Author Question: A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse ... (Read 23 times)

folubunmi · **on:** Jul 23, 2018

A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?

1. Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
2. Up-regulation decreases the number of receptors on the cell-wall surface.
3. Up-regulation requires time for regrowth of cell-wall hormone receptors.
4. Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.

Question 2

The nurse is caring for a client who had been receiving supplemental cortisone. The client developed a bleeding ulcer, and the steroid was discontinued.

The bleeding has stopped but the blood pressure remains unstable. The nurse recognizes that the unstable blood pressure is related to:
1. down-regulation of corticosteroid receptors.
2. up-regulation of epinephrine.
3. up-regulation of corticosteroid receptors.
4. down-regulation of epinephrine.

CharlieArnold · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Sensitivity of individual receptors is not an issue.
Rationale 2: Cell-wall receptors do not decrease in number.
Rationale 3: When a hormone that was administered in large doses is discontinued, it takes several days for cells to produce enough protein receptors to capture endogenous hormone. Tapering the dose allows time for the process to finish before the hormone is stopped.
Rationale 4: The shape of the receptors is unchanged.
Global Rationale: When a hormone that was administered in large doses is discontinued, it takes several days for cells to produce enough protein receptors to capture endogenous hormone. Tapering the dose allows time for the process to finish before the hormone is stopped. Sensitivity of individual receptors is not the issue. Cell-wall receptors do not decrease in number and the shape of the receptors is unchanged.

Answer to Question 2

Correct Answer: 1
Rationale 1: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation.
Rationale 2: Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.
Rationale 3: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation. It takes several days for cells to grow enough new receptors to capture all the available endogenous steroid. That process is known as up-regulation.
Rationale 4: Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.
Global Rationale: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation. It takes several days for cells to grow enough new receptors to capture all the available endogenous steroid. That process is known as up-regulation. Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.