Chapter 33: Adrenal Drugs Test, Prednisone, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Adrenal Drugs Test, Long-Term Prednisone Therapy, Treatment of Asthma, Weight Gain, Patient, Therapy, Nurse, Adrenal, Pharmacology, Prednisone, Corticosteroid, Nonsteroidal Anti-Inflammatory Drugs, Glucocorticoid Therapy, Peptic ulcer disease
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?
Weight gain
Pale skin color
Weight loss
Hair loss
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.
A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber’s orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?
Opioid analgesics
Antidepressants
Nonsteroidal anti-inflammatory drugs
The use of corticosteroids with aspirin, other NSAIDs, and other ulcerogenic drugs produces additive gastrointestinal effects and an increased chance for the development of gastric ulcers. 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?
Tuberculous meningitis
Peptic ulcer disease
Chronic obstructive pulmonary disease
Cerebral edema
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.
When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse will monitor for signs of which condition?
Hypokalemia
Hyponatremia
Hypoglycemia
Dehydration
Systemic glucocorticoid drugs may cause potassium depletion, hyperglycemia, and hypernatremia. The other options are incorrect.
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?
Muscle weakness
Hypotension
Osteoporosis
Delayed wound healing
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.
The nurse expects that a patient is experiencing undersecretion of adrenocortical hormones when which conditions are found upon assessment? (Select all that apply.)
Increased blood glucose levels
Weight loss
Steroid psychosis
Increased potassium levels
Decreased serum sodium levels
Dehydration
The undersecretion (hyposecretion) of adrenocortical hormones causes a condition known as Addison’s disease, which is associated with decreased blood sodium and glucose levels, increased potassium levels, dehydration, and weight loss. Steroid psychosis is an effect of glucocorticoid excess.