Adrenal Drugs

Question 1

Which is a true statement about prednisone (Winpred®)?
a. It is a short-acting glucocorticoid.
b. It has potent mineralocorticoid activity.
c. It is the preferred oral glucocorticoid for anti-inflammatory purposes.
d. It may be administered by inhalation for the treatment of bronchial asthma.

Answer 1

ANS: C
Prednisone is the preferred oral glucocorticoid for anti-inflammatory purposes and is intermediate acting

Question 2

What important information about taking adrenal drugs is appropriate for the nurse to give a patient?
a. To maximize their absorption, oral drugs should be taken before meals.
b. The patient should rinse the oral cavity after using the steroid inhalers.
c. Corticosteroids should be taken before bedtime to minimize adrenal suppression.
d. The medication is to be immediately discontinued if a weight gain of more than 2.25 kg occurs in 1 week.

Answer 2

NS: B
After using the steroid inhalers, rinsing the oral cavity helps to prevent oral fungal infections from developing. Adrenal drugs should be taken with meals in order to minimize gastrointestinal upset and in the morning to minimize adrenal suppression. Adrenal drugs should be discontinued by weaning, not by stopping abruptly.

Question 3

Which type of drugs can have an adverse interaction with corticosteroids?
a. Nonsteroidal anti-inflammatory drugs (NSAIDs)
b. Antibiotics
c. Narcotic analgesics
d. Oral anticoagulants

Answer 3

ANS: A
The use of corticosteroids with NSAIDs produces adverse gastrointestinal effects.

Question 4

A patient is concerned about the body changes that have resulted from long-term prednisone (Winpred®) therapy for the treatment of lupus erythematosus. Which effect of this drug therapy supports the nursing diagnosis of disturbed body image?
a. Weight loss
b. Weight gain
c. Pale skin colour
d. Loss of hair

Answer 4

ANS: B
Facial erythema, weight gain, hirsutism, and “moon face” (characteristic of Cushing’s syndrome) are body changes that may occur with long-term prednisone therapy.

Question 5

A patient is taking fludrocortisone (Florinef®) for Addison’s disease. His wife is concerned about all the problems that may occur with this therapy.
Which is a true statement about fludrocortisone therapy?
a. It may cause severe postural hypotension.
b. To minimize gastrointestinal upset, the medication should be taken with food or milk.
c. The medication should be stopped immediately if nausea or vomiting occurs.
d. Weight gain of 2.3 kg or more in 1 week is an expected adverse effect.

Answer 5

ANS: B
To minimize gastrointestinal upset, patients receiving fludrocortisone should take it with food or milk. Hypotension is a sign and symptom of Addison’s disease or adrenal insufficiency; it will not result from taking fludrocortisone. Weight gain of more than 1 kg in 24 hours or 2.3 kg in 1 week should be reported to the physician. Abrupt withdrawal is not recommended, because it may precipitate an adrenal crisis.

Question 6

What may be caused by systemically administered glucocorticoids? a. Dehydration
b. Hypokalemia
c. Hyperkalemia
d. Hypoglycemia

Answer 6

ANS: C
Systemic glucocorticoid drugs may cause hyperkalemia.

Question 7

Which are the expected symptoms of undersecretion of adrenocortical hormones?
a. Osteoporosis
b. Steroid psychosis
c. Dehydration and weight loss
d. Water retention

Answer 7

ANS: C
Dehydration and weight loss are associated with undersecretion of adrenocortical hormones (Addison’s disease).

Question 8

Which are contraindications to the administration of glucocorticoid drugs?
a. Glaucoma and mental health illnesses
b. Peptic ulcer disease and dizziness
c. Varicella and headaches
d. Cataracts and nausea

Answer 8

ANS: A
Contraindications to the administration of glucocorticoids include glaucoma, mental health illnesses, drug allergies, cataracts, peptic ulcer disease, and diabetes; glucocorticoids can intensify these diseases and conditions. These drugs are also often avoided in cases of infection.