Question 1

A patient is taking fludrocortisone (Florinef)for Addison's disease,and his wife is concerned about all of the problems that may occur with this therapy.When teaching them about therapy with this drug,the nurse will include which information?

A) It may cause severe postural hypotension.
B) It needs to be taken with food or milk to minimize gastrointestinal upset.
C) The medication needs to be stopped immediately if nausea or vomiting occurs.
D) Weight gain of 5 pounds or more in 1 week is an expected adverse effect.

Accepted Answer

Fludrocortisone can cause gastrointestinal upset, so taking it with food or milk can help minimize this side effect. Option A is incorrect because fludrocortisone can actually help with orthostatic hypotension. Option C is incorrect because suddenly stopping fludrocortisone can cause adrenal crisis. Option D is incorrect because while weight gain is a possible side effect of fludrocortisone, gaining 5 pounds or more in a week is not expected and should be reported to the healthcare provider.

Question 2

A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma.Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image?

A) Weight loss
B) Weight gain
C) Pale skin color
D) Hair loss

Weight gain

Accepted Answer

Long-term prednisone therapy can lead to weight gain due to increased appetite and fluid retention. This change in body size and shape can significantly impact a patient's body image and self-esteem, leading to a diagnosis of disturbed body image. Weight loss, pale skin color, and hair loss may also be side effects of prednisone, but they are less commonly associated with disturbed body image.

Question 3

When monitoring a patient who is taking a systemically administered glucocorticoid,the nurse will monitor for signs of which condition?&#10;A) Dehydration&#10;B) Hypokalemia&#10;C) Hyponatremia&#10;D) Hypoglycemia

Accepted Answer

Systemic glucocorticoid drugs may cause potassium depletion, hyperglycemia, and hypernatremia. The other options are incorrect.

Question 4

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?

A) Hypotension
B) Delayed wound healing
C) Muscle weakness
D) Osteoporosis

Accepted Answer

Long-term corticosteroid use can lead to delayed wound healing due to its ability to inhibit inflammation and immune response, which are important in the healing process. While hypotension, muscle weakness, and osteoporosis are also potential effects of corticosteroid use, they may not have as significant an impact on the patient's recovery from surgery.

Question 5

A patient will be starting therapy with a corticosteroid.The nurse reviews the patient's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?&#10;A) Nonsteroidal anti-inflammatory drugs&#10;B) Antibiotics&#10;C) Opioid analgesics&#10;D) Antidepressants

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of gastrointestinal bleeding and ulceration when taken with corticosteroids. Close monitoring and possible adjustments in therapy may be necessary. Antibiotics, opioid analgesics, and antidepressants do not have significant interactions with corticosteroids.

Question 6

A glucocorticoid is prescribed for a patient.The nurse checks the patient's medical history knowing that glucocorticoid therapy is contraindicated in which disorder?&#10;A) Cerebral edema&#10;B) Peptic ulcer disease&#10;C) Tuberculous meningitis&#10;D) Chronic obstructive pulmonary disease

Accepted Answer

Glucocorticoid therapy is contraindicated in peptic ulcer disease because it can increase the risk of gastrointestinal bleeding and perforation in patients with this condition.

Question 7

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._______

Accepted Answer

The answer of A patient has been admitted for an...

Question 8

The nurse is administering adrenal drugs to a patient.Which action by the nurse is appropriate for this patient?&#10;A) Administering oral drugs on an empty stomach to maximize absorption&#10;B) Rinsing the oral cavity after using corticosteroid inhalers&#10;C) Administering the corticosteroids before bedtime to minimize adrenal suppression&#10;D) Discontinuing the medication immediately if weight gain of 5 pounds or more in 1 week occurs

Accepted Answer

Rinsing the oral cavity after using corticosteroid inhalers helps to decrease the risk of oral fungal infections such as thrush. The other options listed are incorrect. Adrenal drugs should not be administered on an empty stomach as this can increase the risk of gastrointestinal upset. Corticosteroids should be administered in the morning to mimic the natural diurnal variation in cortisol levels and minimize adrenal suppression. Discontinuing medication abruptly can cause adrenal crisis and should only be done under the guidance of a healthcare provider.

Deck 33: Adrenal Drugs