A patient has been taking oral prednisone 60 mg daily for 3 days ...

[washai]

A patient has been taking oral prednisone 60 mg daily for 3 days for an asthma exacerbation, which has resolved. The patient reports having gastrointestinal (GI) upset. The primary care nurse practitioner (NP) should:
 
  a. discontinue the prednisone.
  b. begin tapering the dose of the prednisone.
  c. order a proton pump inhibitor (PPI) to counter the effects of the steroid.
  d. change the prednisone dosing to every other day.

Question 2

A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition.
 
  The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend: a. a daily bulk laxative.
  b. long-term docusate sodium.
  c. a saline laxative as needed.
  d. glycerin suppositories as needed.

[xiaomengxian]

Answer to Question 1

A
The patient's asthma symptoms have resolved, so the prednisone may be discontinued. If the patient has been on the medication for a few days, it is not necessary to taper the dose before the patient stops taking it. If the patient required long-term dosing of the steroid, a PPI could be used. Every-other-day dosing is used. Alternate-day dosing is sometimes used for long-term therapy to minimize suppression of the hypothalamic-pituitary-adrenal (HPA) axis.

Answer to Question 2

C
Mild short-term constipation may be treated with a saline laxative or a bulk laxative as needed. Daily laxatives are not recommended. Glycerin suppositories can cause irritation of the rectum with long-term use.

[washai]

Excellent

[Liddy]

Great answer, keep it coming