Corticosteroids

Every question here, with the answer

1. A client who has taken prednisone for several months says they want to stop it because they feel better. What should the nurse teach?

   1. Do not stop it abruptly; the dose must be reduced gradually to avoid adrenal insufficiency.
   2. Switch to double doses on bad days only.
   3. Skip every other dose for a week, then stop.
   4. Stop it today since symptoms are controlled.

   Answer: Do not stop it abruptly; the dose must be reduced gradually to avoid adrenal insufficiency.

   Stopping corticosteroids abruptly can lead to adrenal insufficiency, so after long-term therapy the drug is reduced gradually. Stopping, skipping, or doubling doses on one's own is unsafe.

2. A client using a fluticasone inhaler has white patches in the mouth. Which teaching point addresses this problem?

   1. Take the inhaler with food.
   2. Use the inhaler less often than prescribed.
   3. Rinse the mouth after each use of the inhaled corticosteroid.
   4. Use a second inhaler to wash the medicine down.

   Answer: Rinse the mouth after each use of the inhaled corticosteroid.

   Candidiasis, an oral fungal infection, is a side effect of corticosteroids, and rinsing the mouth after inhalation reduces the risk. Skipping doses is discouraged, and food is advised for oral, not inhaled, corticosteroids.

3. A nurse is caring for a client taking oral prednisone. Which assessments should the nurse include? Select all that apply.

   1. Hearing acuity
   2. Potassium level
   3. Daily weight
   4. Sleep patterns
   5. Blood pressure

   Answer: Potassium level, Daily weight, Sleep patterns, Blood pressure

   The nurse monitors blood pressure, sleep patterns, potassium levels, and weight in clients taking corticosteroids. Hearing is not a listed assessment.

4. A client taking prednisone weighs 2 pounds more today than yesterday and 5 pounds more than last week. What should the nurse tell the client?

   1. This weight gain should be reported to the health care provider.
   2. Weight gain is never related to corticosteroids.
   3. Weigh yourself only once a month.
   4. Stop the prednisone to lose the weight.

   Answer: This weight gain should be reported to the health care provider.

   Clients report a weight gain of more than 2–3 pounds over 24 hours or 5 pounds in a week, and weight gain is a known corticosteroid effect. Stopping the drug abruptly is unsafe, and clients weigh themselves daily.

5. Which clients should NOT receive a corticosteroid? Select all that apply.

   1. A client with COPD
   2. A client with asthma
   3. A client with a systemic fungal infection
   4. A client with hypersensitivity to the drug
   5. A client who just received a live vaccine

   Answer: A client with a systemic fungal infection, A client with hypersensitivity to the drug, A client who just received a live vaccine

   Clients with hypersensitivity, systemic fungal infections, or recent live vaccines should not use corticosteroids. Asthma and COPD are the conditions corticosteroids are used to treat.

6. A client with type 2 diabetes is starting oral prednisone. Which teaching is most important?

   1. Take prednisone on an empty stomach.
   2. Avoid wearing a medical ID bracelet.
   3. You no longer need to check your blood glucose.
   4. Monitor your blood glucose carefully.

   Answer: Monitor your blood glucose carefully.

   Clients with diabetes taking corticosteroids should monitor glucose carefully, and hyperglycemia is a listed adverse effect. Oral corticosteroids are taken with food, and a medical ID bracelet is recommended.