Author Question: A patient with severe asthma has taken high-dose glucocorticoids for 2 months. The symptoms have ... (Read 59 times)

Tirant22 · **on:** Jul 23, 2018

A patient with severe asthma has taken high-dose glucocorticoids for 2 months. The symptoms have resolved, and the patient is ready to stop the medication. What patient education would the nurse provide about discontinuing the medication?

a. The dose should be tapered off over 7 to 10 days.
b. The drug can be stopped immediately if it is no longer needed.
c. The drug must be continued for life.
d. An inhaled form of glucocorticoid must be added to the medication regimen.

Question 2

The family of a patient who has been on long-term corticosteroids brings him to the emergency department. The wife states that, He just started coughing forcefully and began complaining of chest pain.

Now he is having a little difficulty breathing. The nurse should assess the patient for
a. muscle spasm.
b. myocardial infarction.
c. broken ribs.
d. pleuritis.

tashiedavis420 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
To minimize the impact of adrenal insufficiency, glucocorticoid withdrawal should be gradual.
Abrupt termination of long-term therapy of high-dose glucocorticoids may result in adrenal crisis.
The drug should not be continued for life unless it is taken because of adrenal gland removal.
An inhaled form could be used but is not required.

Answer to Question 2

ANS: C
Because the patient has been on long-term therapy with corticosteroids, he is at risk for osteoporosis. The most common areas affected are the ribs and vertebrae, which are subject to osteoporotic fractures. The nurse should assess the patient for broken ribs, because he was coughing forcefully and now is having difficulty breathing.
Nothing indicates that the patient has a muscle spasm.
There is no apparent indication that the patient is experiencing a myocardial infarction.
Nothing indicates that the patient has pleuritis.