A nurse is caring for a client who was prescribed high-dose ...

[penza]

A nurse is caring for a client who was prescribed high-dose corticosteroid therapy for 1 month to treat a severe inflammatory condition. The client's symptoms have now resolved and the client asks, When can I stop taking these medications?
 
  How should the nurse respond?
  a.
  It is possible for the inflammation to recur if you stop the medication.
  b.
  Once you start corticosteroids, you have to be weaned off them.
  c.
  You must decrease the dose slowly so your hormones will work again.
  d.
  The drug suppresses your immune system, which must be built back up.

Question 2

A nurse cares for a client with adrenal hyperfunction. The client screams at her husband, bursts into tears, and throws her water pitcher against the wall. She then tells the nurse, I feel like I am going crazy. How should the nurse respond?
 
  a. I will ask your doctor to order a psychiatric consult for you.
  b. You feel this way because of your hormone levels.
  c. Can I bring you information about support groups?
  d. I will close the door to your room and restrict visitors.

[diana chang]

Answer to Question 1

ANS: B
One of the most common causes of adrenal insufficiency, a life-threatening problem, is the sudden cessation of long-term, high-dose corticosteroid therapy. This therapy suppresses the hypothalamic-pituitary-adrenal axis and must be withdrawn gradually to allow for pituitary production of adrenocorticotropic hormone and adrenal production of cortisol. Decreasing hormone therapy slowly ensures self-production of hormone, not hormone effectiveness. Building the client's immune system and rebound inflammation are not concerns related to stopping high-dose corticosteroids.

Answer to Question 2

ANS: B
Hypercortisolism can cause the client to show neurotic or psychotic behavior. The client needs to know that these behavior changes do not reflect a true psychiatric disorder and will resolve when therapy results in lower and steadier blood cortisol levels. The client needs to understand this effect and does not need a psychiatrist, support groups, or restricted visitors at this time.

[penza]

TYSM

[sultansheikh]

Excellent