Glucocorticoids – Pharmacology for Nurses: Practical Apps

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Chapter 33: Adrenal Drugs Test, Glucocorticoids, Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Adrenal Drugs Test, Glucocorticoids, Block, Patient, Medication, Pharmacology, Nurse, Pain Management, Acetaminophen, Chronic Obstructive Pulmonary Disease, Regulate Carbohydrate, Fat, and Protein Metabolism, Methylprednisolone (Solu-Medrol)


When discussing glucocorticoids to a patient, what statement by the nurse is accurate regarding the action of these medications?

They stimulate defense mechanisms to produce immunity.

They regulate carbohydrate, fat, and protein metabolism.

They are produced in lower amounts during times of stress.

They decrease serum sodium and glucose levels.

Glucocorticoids play a major role in carbohydrate, lipid, and protein metabolism within the body. They are produced in increasing amounts during stress, increase sodium and glucose levels, and suppress the immune system.


Discharge teaching for a patient receiving glucocorticoids would include the use of which medication for pain management?

Acetaminophen

Aspirin

Ibuprofen

Naprosyn

Acetaminophen does not cause GI distress as do aspirin, ibuprofen, naproxen, and glucocorticoids. Acetaminophen is the medication of choice for treatment of pain in a patient receiving glucocorticoids.


Based on the nurse’s knowledge of glucocorticoids, what instructions should be given for this drug?

Take the medication every evening.

Advise to take drug with milk, other dairy products, or food.

Inform the patient that the drug can be taken with coffee.

Advise that the drug does not have to be tapered before stopped.

Glucocorticoids can cause gastrointestinal (GI) distress and should be given with milk or food. They should not be administered with coffee, which contains caffeine and may increase gastric irritation. The best time to give exogenous glucocorticoids is early in the morning (6 A.M. to 9 A.M.) to minimize the amount of adrenal suppression. These medications should be tapered off slowly to prevent adrenal crisis and can be administered intravenously (IV).


The nurse is administering an adrenal drug to a patient. Which action by the nurse is appropriate for this patient?

Rinsing the oral cavity after using corticosteroid inhalers

Discontinuing the medication immediately if weight gain of 5 pounds or more in 1 week occurs

Administering the corticosteroids before bedtime to minimize adrenal suppression

Administering oral adrenal drugs on an empty stomach to maximize absorption

After the patient has used the corticosteroid inhalers, cleaning the oral cavity helps to prevent possible oral fungal infections from developing. Adrenal drugs need 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.


A patient has been admitted for an exacerbation of chronic obstructive pulmonary disease and will be receiving methylprednisolone (Solu-Medrol) 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

40 mg:1 mL :: 30 mg:x mL.
(40 mg × x) = (1 × 30); 40x = 30; x = 0.75, therefore x = 0.75 mL.