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Author Question: A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid ... (Read 62 times)

mikaylakyoung

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A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?
 
  a. I should reduce the dose by half each day until I stop taking the drug.
  b. I will need to have cortisol levels moni-tored during the withdrawal process.
  c. The withdrawal schedule may take sev-eral months.
  d. If I have surgery, I may need to take the drug for a while, even after I have stopped.

Question 2

The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn't just order an antibiotic for the child's current symptoms of low-grade fever, flank pain, and dysuria since these
 
  are similar symptoms as before. Which is the most important reason given by the nurse? a. Your child may need to be hospitalized for treatment.
  b. Your child may need a urine culture be-fore and after treatment.
  c. Your child may need tests to assess for urinary tract abnormalities.
  d. Your child may need additional medica-tions, such as urinary tract antiseptics.



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Athena23

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Answer to Question 1

A
Glucocorticoid therapy can suppress adrenal function, so withdrawal should be done slowly to allow recovery of adrenal function. Reducing the dose of a glucocorticoid by half each day is not recommended. Patients should have their cortisol levels monitored to determine when therapy can be stopped. The withdrawal schedule may take several months. Patients who have stopped the drug may still experience adrenal insufficiency in times of physiologic stress, such as surgery.

Answer to Question 2

C
Children with recurrent urinary tract infections should be assessed for underlying urinary tract abnormalities to help determine a possible cause for recurrence. This child has mild fever and therefore may not require hospitalization. Urine cultures are important when treating patients with recurrent UTI prophylactically, but this is not the most important consideration. Urinary tract antiseptics are used to treat uncomplicated lower urinary tract infections.





 

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