A 38-year-old male patient is admitted to the hospital in ...

[xclash]

A 38-year-old male patient is admitted to the hospital in Addisonian crisis. Which patient statement supports a nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addison's disease?
 
  a. I frequently eat at restaurants, and my food has a lot of added salt.
  b. I had the stomach flu earlier this week, so I couldn't take the hydrocortisone.
  c. I always double my dose of hydrocortisone on the days that I go for a long run.
  d. I take twice as much hydrocortisone in the morning dose as I do in the afternoon.

Question 2

A 29-year-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include?
 
  a. Weigh yourself daily to monitor for weight gain caused by increased appetite.
  b. A weight-bearing exercise program will help minimize the risk for osteoporosis.
  c. The prednisone dose should be decreased gradually rather than stopped suddenly.
  d. Call the health care provider if you experience mood alterations with the prednisone.

[rachel]

Answer to Question 1

ANS: B
The need for hydrocortisone replacement is increased with stressors such as illness, and the patient needs to be taught to call the health care provider because medication and IV fluids and electrolytes may need to be given. The other patient statements indicate appropriate management of the Addison's disease.

Answer to Question 2

ANS: C
Acute adrenal insufficiency may occur if exogenous corticosteroids are suddenly stopped. Mood alterations and weight gain are possible adverse effects of corticosteroid use, but these are not life-threatening effects. Osteoporosis occurs when patients take corticosteroids for longer periods.