The nurse provides medication teaching to a client with primary adrenal insufficiency (Addison's disease) who is prescribed hydrocortisone 10 mg by mouth 3 times a day. Which instructions should be included in the client's teaching plan? Select all that apply.

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Clients taking long-term corticosteroid replacement should be taught the following: Do not discontinue glucocorticoid therapy abruptly. Abrupt discontinuation could lead to addisonian crisis, a life-threatening complication (Option A). Report any signs and symptoms of infection to the HCP immediately. Corticosteroid use can cause immunosuppression, and infection can develop quickly and spread rapidly. Corticosteroids' anti-inflammatory effects may also mask signs of infection such as inflammation, redness, tenderness, heat, fever, and edema (Option C). Stay attuned to signs and symptoms of stress and increase dose of corticosteroid during times of stress. A stress response (surgery, trauma) can cause a sudden decrease in cortisol levels, triggering addisonian crisis (Option F). A side effect of corticosteroid therapy is hyperglycemia. Report signs of hyperglycemia, including increased urine, hunger, and thirst. Clients with diabetes mellitus must be vigilant in checking blood glucose levels (Option D). Corticosteroids are catabolic to bone (osteoporosis) and muscle (muscle weakness). A diet high in calcium (at least 1500 mg/day) and protein (1.5 g/kg/day) but low in fat and simple carbohydrates is recommended. Cataracts are a side effect of corticosteroids, particularly glucocorticoid therapy. Make an appointment with an optometrist yearly to assess for cataracts (Option B). Corticosteroid medications can cause gastric irritation and should not be taken on an empty stomach (Option E). Recognize signs and symptoms of Cushing syndrome and report to the PHCP. Develop a regular HCP-approved exercise program. Educational objective: Corticosteroids are the primary drugs used to treat Addison's disease. It is imperative that the nurse teach the client about this medication, including points such as never to stop it abruptly, notify the HCP of signs and symptoms of infection, and monitor blood glucose closely if diabetes is a comorbid condition.

The Nurse Provides Medication Teaching to a Client with Primary