Chapter 33: Adrenal Drugs Test, Dermatitis, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Adrenal Drugs, Nurse, Patient, Adrenal, Prevent, Prescription, Disease, Adverse, Steroid, Prednisone, Dermatitis,
The nurse has a prescription for a patient to receive prednisone to treat contact dermatitis. The nurse would question this prescription for this patient with what condition?
Asthma
Chronic obstructive pulmonary disease
Multiple sclerosis
Acquired immune deficiency syndrome
Because of their immunosuppressant properties, glucocorticoids are often avoided in the presence of any serious infection, including septicemia, systemic fungal infections, and varicella. These drugs would be contraindicated in patients with active AIDS infection because it could potentially decrease the immune system further. One exception is tuberculous meningitis, for which glucocorticoids may be used to prevent inflammatory central nervous system damage.
The nurse would question a prescription for steroids in a patient with which condition?
Rheumatoid arthritis
Diabetes mellitus
Asthma
Spinal cord injury
A common adverse effect of steroid therapy is hyperglycemia; therefore, diabetes mellitus is a contraindication to steroid therapy.
To prevent the development of oral candidiasis when using corticosteroid inhalers, which instruction is accurate for the nurse to teach the patient?
Swish and swallow with Mycostatin after each use.
Minimize use of an inhaler to every other day.
Rinse the mouth after each use.
Report any gingival irritation to the health care provider.
It is most important to teach patients to rinse their mouths with lukewarm water after each use of a steroid inhaler to prevent the occurrence of oral candidiasis, a fungal infection. Mycostatin is not routinely used to prevent this infection unless the patient is immunocompromised. Reporting irritation after it has occurred does not prevent the infection. Minimizing the use of the inhaler to every other day negates its therapeutic effect.
A pediatric patient has been prescribed methylprednisolone (Solu-Medrol) for an allergic response to food. The dose prescribed is 0.5 mg/kg IV every 6 hours. The patient’s weight is 11.4 kg. How many milligrams (mg) will the nurse administer for one dose? __Note: mg must be placed in your answer for it to count.
Correct Answers
5.7 mg
The patient’s weight of 11.4 kg is multiplied by 0.5 mg/kg, which equals 5.7 mg.
When assessing for potential adverse effects of fludrocortisone, the nurse monitors for signs and symptoms of which condition?
Hypercalcemia
Hypovolemia
Hypokalemia
Hyponatremia
Fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention along with potassium excretion. Thus, a potential adverse effect is hypokalemia. Assessing for signs and symptoms of hypokalemia and close monitoring of electrolytes are needed.
The nurse should question a prescription for aminoglutethimide in a patient with which condition?
Metastatic breast cancer
Addison’s disease
Adrenal malignancy
Cushing’s syndrome
Aminoglutethimide suppresses the adrenal cortex. Addison’s disease presents with decreased adrenal secretion; thus, you would not want to exacerbate this by administering aminoglutethimide. All of the other choices are diagnosis and indications for use for aminoglutethimide.
The order reads , ” Give dexamethasone 1.5 mg , twice a day. The medication is available in 3-mg tablets. How many tablets will the nurse give for each dose? note : tablet must follow your answer to get full credit.
Correct Answer
1/2 tablet