Author Question: A client on long-term corticosteroid therapy is demonstrating signs of acute adrenocortical ... (Read 45 times)

nautica902 · **on:** Jul 23, 2018

A client on long-term corticosteroid therapy is demonstrating signs of acute adrenocortical insufficiency. The nurse knows that these symptoms are caused by:

Standard Text: Select all that apply.
1. the shutting down of ACTH secretion.
2. the failure of the adrenal cortex to secrete corticosteroids.
3. rebound ACTH secretion.
4. excessive secretion of ACTH.
5. toxic levels of mineralocorticoids.

Question 2

The nurse instructs a client receiving long-term corticosteroid replacement therapy to have annual eye examinations because of the risk of developing:

Standard Text: Select all that apply.
1. glaucoma.
2. cataracts.
3. detached retina.
4. retinopathy.
5. macular degeneration.

AaaA · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,2
Rationale 1: Consistent high amounts of corticosteroid medications provide continuous negative feedback to the hypothalamus and pituitary, shutting down the secretion of ACTH.
Rationale 2: Without stimulation by ACTH, the adrenal cortex shrinks and stops secreting endogenous corticosteroids.
Rationale 3: Acute adrenocortical insufficiency is not caused by rebound ACTH secretion.
Rationale 4: Acute adrenocortical insufficiency is not caused by excessive secretion of ACTH.
Rationale 5: Mineralocorticoids do not cause acute adrenal insufficiency.
Global Rationale: Consistent high amounts of corticosteroid medications provide continuous negative feedback to the hypothalamus and pituitary, shutting down the secretion of ACTH. Without stimulation by ACTH, the adrenal cortex shrinks and stops secreting endogenous corticosteroids. Acute adrenocortical insufficiency is not caused by rebound ACTH secretion, by excessive secretion of ACTH, or by mineralocorticoid levels.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: Open-angle glaucoma is a frequent adverse effect of long-term corticosteroid therapy.
Rationale 2: Cataracts are a frequent adverse effect of long-term corticosteroid therapy.
Rationale 3: Detached retina is not an adverse effect of long-term corticosteroid therapy.
Rationale 4: Retinopathy is not an adverse effect of long-term corticosteroid therapy, although it might occur as an effect of uncontrolled blood glucose levels, as seen in diabetes mellitus.
Rationale 5: Macular degeneration is not an adverse effect of long-term corticosteroid therapy.
Global Rationale: Open-angle glaucoma and cataracts are frequent adverse effects of long-term corticosteroid therapy. Retinopathy is not an adverse effect of long-term corticosteroid therapy, although it might occur as an effect of uncontrolled blood glucose levels, as seen in diabetes mellitus. Macular degeneration and detached retina are not adverse effects of long-term corticosteroid therapy.