Nokea
A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which expected effect of this drug therapy would cause a change in the patient's appearance?
- A. Weight loss
- B. Weight gain
- C. Pale skin color
- D. Hair loss
Correct Answer: B
Rationale: Facial erythema, weight gain, hirsutism, and 'moon face' (characteristic of Cushing's syndrome) are possible body changes that may occur with long-term prednisone therapy.
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The nurse is reviewing therapy with glucocorticoid drugs. Which conditions are indications for glucocorticoid drugs?
- A. Glaucoma
- B. Cerebral edema
- C. Chronic obstructive pulmonary disease
- D. Organ transplantation
- E. Varicella
- F. Septicemia
Correct Answer: B,C,D
Rationale: Cerebral edema, chronic obstructive pulmonary disease, and organ transplantation are indications for glucocorticoid therapy. Glaucoma, varicella, and septicemia are all contraindications to glucocorticoid therapy.
A patient is taking fludrocortisone for Addison's disease, and his wife is concerned about all of the problems that may occur with this therapy. When teaching them about therapy with this drug, the nurse will include which information?
- A. It may cause severe postural hypotension.
- B. It needs to be taken with food or milk to minimize gastrointestinal upset.
- C. The medication needs to be stopped immediately if nausea or vomiting occurs.
- D. Weight gain of 5 pounds or more in 1 week is an expected adverse effect.
Correct Answer: B
Rationale: Patients receiving fludrocortisone need to take it with food or milk to minimize gastrointestinal upset. Weight gain of 5 pounds or more in 1 week needs to be reported to the physician, abrupt withdrawal is not recommended because it may precipitate an adrenal crisis. Adverse effects are related to fluid retention and may include heart failure and hypertension.
A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient's recovery?
- A. Hypotension
- B. Osteoporosis
- C. Muscle weakness
- D. Delayed wound healing
Correct Answer: D
Rationale: Muscle weakness and osteoporosis may also result from long-term therapy, but delayed wound healing would have the most impact on the patient's recovery from abdominal surgery at this time. Hypertension, not hypotension, may result from long-term corticosteroid therapy.
A glucocorticoid is prescribed for a patient. The nurse checks the patient's medical history knowing that glucocorticoid therapy is contraindicated in which disorder?
- A. Cerebral edema
- B. Peptic ulcer disease
- C. Tuberculous meningitis
- D. Chronic obstructive pulmonary disease
Correct Answer: B
Rationale: Contraindications to the administration of glucocorticoids include drug allergy and may include cataracts, glaucoma, peptic ulcer disease, mental health problems, and diabetes mellitus. The other options are indications for glucocorticoids.
A patient has been admitted for an exacerbation of chronic obstructive pulmonary disease and will be receiving methylprednisolone 30 mg intravenously every 6 hours. The medication is available in 40 mg/mL vials. Identify how many milliliters will the nurse draw up for this dose.
Correct Answer: 0.75 mL
Rationale: 40 mg : 1 mL :: 30 mg : x mL; (40 * x) = (1 * 30); 40x = 30; x = 30/40 = 0.75 mL.