Nokea
The nurse is administering an adrenal drug to a patient. Which action by the nurse is appropriate for this patient?
- A. Administering oral adrenal drugs on an empty stomach to maximize absorption
- B. Rinsing the oral cavity after using corticosteroid inhalers
- C. Administering the corticosteroids before bedtime to minimize adrenal suppression
- D. Discontinuing the medication immediately if weight gain of 5 pounds or more in 1 week occurs
Correct Answer: B
Rationale: After the patient has used corticosteroid inhalers, cleaning the oral cavity helps to prevent possible oral fungal infections from developing. Adrenal drugs need to be taken with meals to minimize gastrointestinal upset and in the mornings to minimize adrenal suppression, and they need to be discontinued by weaning, not abruptly.
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When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse will monitor for signs of which condition?
- A. Dehydration
- B. Hypokalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: B
Rationale: Systemic glucocorticoid drugs may cause potassium depletion, hyperglycemia, and hypernatremia. The other options are incorrect.
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 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.
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 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.