Deck 37: Corticosteroids

Question 1

Which measure(s)for monitoring hydration and fluid balance would be inappropriate for the patient on steroid therapy?

A) Daily weights
B) Abdominal girth measurements
C) Reports of thirst
D) Neurologic assessment
E) Assessment for alteration in skin integrity

Answer 1

Daily weights
Abdominal girth measurements

Question 2

A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone)therapy for rheumatoid arthritis.Which information will the nurse include in discharge teaching?

A) "Daily, single dose therapy should be taken in the morning."
B) "The metabolic needs of your body will be increased."
C) "Steroids should never be discontinued abruptly."
D) "Signs and symptoms of infections may not be evident."
E) "Blood glucose levels will be elevated on corticosteroid therapy."

Answer 2

"Daily, single dose therapy should be taken in the morning."
"Steroids should never be discontinued abruptly."
"Signs and symptoms of infections may not be evident."
"Blood glucose levels will be elevated on corticosteroid therapy."

Question 3

What is the rationale for monitoring vital signs of patients receiving corticosteroids?

A) Orthostatic hypotension
B) Malignant hyperthermia
C) Infection
D) Hyperglycemia

Answer 3

Infection

Question 4

What is the rationale for administering glucocorticoid therapy as an adjunct to chemotherapeutic agents?

A) Assists with pain control
B) Raises blood sugar to meet the increased metabolic needs
C) Produces immunosuppression effects
D) Reduces mucositis

Question 5

The nurse is instructing a patient about adverse effects associated with corticosteroid therapy.What information would be important to include?

A) Avoid crowds or people with an infection.
B) Monitor and care for your skin daily; change positions frequently.
C) Take medication on an empty stomach.
D) During periods of physical or psychological stress, higher doses of corticosteroids are necessary. Contact your health care provider.
E) Follow a diet low in sodium.

Question 6

What would be primary therapeutic outcome(s)expected from fludrocortisone (Florinef)therapy?

A) Reduced inflammation
B) Pain relief
C) Blood pressure control
D) Restored fluid and electrolyte balance

Question 7

A patient has just received a new prescription for a corticosteroid medication.The nurse is educating a patient on symptoms to report to the health care provider.When providing this education,the nurse will inform the patient to report(Select all that apply.)

A) productive cough.
B) dyspnea.
C) confusion.
D) chest pain.
E) weight gain.
F) All of the above.

Question 8

What are functions of glucocorticoids?

A) Maintain fluid and electrolyte balance
B) Have anti-inflammatory activities
C) Regulate protein, carbohydrate, and fat metabolism
D) Provide relief of rheumatoid arthritis
E) Include aldosterone

Question 9

The nurse is assessing a patient for adverse effects of long-term glucocorticoid therapy.Which condition would most likely be present?

A) Dehydration
B) Hypotension
C) Osteoporosis
D) Thrombocytopenia

Question 10

Which condition would require mineralocorticoid replacement?

A) Addison's disease
B) Diabetes insipidus
C) Myxedema
D) Glomerulonephritis

Question 11

The nurse transcribes a new order for a patient for a fludrocortisone.When planning the time of administration,the nurse will schedule this medication to be given

A) with breakfast and dinner.
B) once daily in the evening.
C) before meals.
D) with lunch.

Question 12

A patient has been diagnosed with rheumatoid arthritis and will begin daily oral corticosteroid treatment.Which baseline assessment(s)would be important for a patient receiving corticosteroids?

A) Baseline weight
B) Blood pressure
C) Complete blood cell count (CBC)
D) Electrolyte studies
E) Hydration status

Question 13

A patient has been on high-dose corticosteroid therapy for the treatment of lupus erythematosus.In addition to monitoring electrolyte levels,which laboratory studies will the nurse monitor?

A) Complete blood count
B) Partial thromboplastin time
C) Liver function panel
D) Blood glucose levels

Question 14

A patient who has been taking glucocorticoids over the past 3 months for Crohn's disease comes in for a follow-up visit.On assessment,the nurse notes facial edema,thinning extremities,and a fatty deposition (buffalo hump)on the scapular area.The patient reports the symptoms of the Crohn's disease are "somewhat better." What will the nurse expect the treatment to be?

A) Decrease the steroid dosage by one half.
B) Increase the steroid dosage.
C) Maintain the steroid dosage.
D) Immediately stop the steroid dosage.

Question 15

Which statement(s)made by a patient on a corticosteroid medication show(s)a need for further education?

A) "I should increase my potassium intake."
B) "I may have to decrease my fluid intake."
C) "I will avoid weight-bearing measures."
D) "I will change position frequently."

Question 16

Which fluid replacement method will the nurse identify for a patient on a fluid restriction?

A) Freely throughout the day and evening shift
B) One third of the allowed volume on each shift
C) Half the volume with meals and the remainder divided among shifts
D) As the patient desires

Question 17

Which will the nurse include in the teaching plan for a patient asking about the use of salt substitutes while on a sodium-restricted diet?

A) Salt substitutes may be high in potassium and should be used sparingly.
B) Salt substitutes are safe for unlimited use.
C) The salty flavor is reduced, so additional amounts are needed for desired flavor.
D) Salt substitutes may interact with the patient's medications.

Question 18

A patient on a high dosage of corticosteroids over a period of time may develop which type of psychiatric complication?

A) Lethargy
B) Psychotic behaviors
C) Manic phases
D) Anxiety attacks

Question 19

A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive pulmonary disease.Which will the nurse expect in the treatment plan?

A) A decrease in the amount of insulin needed
B) No change in the amount of insulin needed
C) An increase in the need for carbohydrates
D) An increase in the insulin needed