Chapter 33: Adrenal Drugs Flashcards
A chronic disease associated with the hyposecretion of corticosteroids.
addison’s disease
The outer portion of the adrenal gland.
adrenal cortex
An acute, life-threatening state of profound adrenocortical insufficiency requiring immediate medical management. It is characterized by glucocorticoid deficiency, a drop in extracellular fluid volume, hyponatremia, and hyperkalemia.
adrenal crisis
The inner portion of the adrenal gland.
adrenal medulla
A mineralocorticoid hormone produced by the adrenal cortex that acts on the renal tubule to regulate sodium and potassium balance in the blood.
aldosterone
The general anatomic term for the outer layers of a body organ or other structure.
cortex
Any of the natural or synthetic adrenocortical hormones; those produced by the cortex of the adrenal gland.
corticosteroids
A metabolic disorder characterized by abnormally increased secretion of the corticosteroids.
cushing’s syndrome
An endogenous hormone secreted into the bloodstream by the adrenal medulla; also a synthetic drug that is an adrenergic vasoconstrictor and increases cardiac output.
epinephrine
A major group of corticosteroid hormones that regulate carbohydrate, protein, and lipid metabolism and inhibit the release of adrenocorticotropic hormone (ACTH).
glucocorticoids
A negative feedback system involved in regulating the release of corticotropin-releasing hormone by the hypothalamus, ACTH (corticotropin) by the pituitary gland, and corticosteroids by the adrenal glands.
hypothalamic-pituitary-adrenal (HPA) axis
An anatomic term for the most interior portions of an organ or structure.
medulla
A major group of corticosteroid hormones that regulate electrolyte and water balance.
mineralocorticoids
An adrenergic hormone, secreted by the adrenal medulla, that increases blood pressure by causing vasoconstriction but does not appreciably affect cardiac output; it is the immediate metabolic precursor to epinephrine.
norepinephrine
When monitoring for a therapeutic response to prednisone, the nurse will look for which potential outcomes? (Select all that apply.)
a. Increased lymphocyte levels
b. Decreased inflammation
c. Increased growth characteristics
d. Decrease in Cushing’s syndrome characteristics
e. Prevention of organ rejection in a patient who had an organ transplant
b. Decreased inflammation
e. Prevention of organ rejection in a patient who had an organ transplant
The nurse has provided teaching about oral corticosteroid therapy to a patient. Which statement by the patient shows a need for more teaching?
a. “I will report any fever or sore throat symptoms.”
b. “I will stay away from anyone who has a cold or infection.”
c. “I can stop this medication if I have severe adverse effects.”
d. “I will take this drug with food or milk.”
c. “I can stop this medication if I have severe adverse effects.”
During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing’s syndrome, which is manifested by which of these? (Select all that apply.)
a. Weight loss
b. Hirsutism
c. Hypotension
d. Thickened hair growth
e. Bruising
f. Muscle atrophy
b. Hirsutism
e. bruising
f. muscle atrophy
When teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression?
a. In the morning
b. At lunchtime
c. At dinnertime
d. At bedtime
a. In the morning
Which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma?
a. “Exhale while pushing in on the canister of the inhaler.”
b. “Blow your nose after taking the medication.”
c. “Rinse your mouth thoroughly after taking the medication.”
d. “Do not eat immediately after taking the medication.”
c. “Rinse your mouth thoroughly after taking the medication.”
During long-term corticosteroid therapy, the nurse will monitor the patient’s laboratory results for adverse effects, such as: (Select all that apply.)
a. Increased serum potassium levels
b. Decreased serum potassium levels
c. Increased sodium levels
d. Decreased sodium levels
e. Hyperglycemia
f. Hypoglycemia
b. Decreased serum potassium levels
c. Increased sodium levels
e. Hyperglycemia
A patient has been taking prednisone as part of treatment for bronchitis, and he notices that the dosage of the medication decreases each day. During a follow-up office visit, he asks the nurse why he must continue the medication and why he cannot just stop taking it now that he feels better. What is the rationale behind the tapering dosages?
a. Sudden discontinuation of this medication may result in adrenal insufficiency.
b. The patient would experience withdrawal symp-toms if the drug were discontinued abruptly.
c. Cushing’s syndrome may develop as a reaction to a sudden drop in serum cortisone levels.
d. When the symptoms have started to disappear, lower dosages are needed.
a. Sudden discontinuation of this medication may result in adrenal insufficiency.
The nurse is reviewing the use of oral glucocorti-coids. Which of these is the preferred oral gluco-corticoid for antiinflammatory or immunosuppressant purposes?
a. Fludrocortisone
b. Dexamethasone
c. Prednisone
d. Hydrocortisone
c. Prednisone
When monitoring a patient who is taking cortico-steroids, the nurse observes for which adverse effects? (Select all that apply.)
a. Fragile skin
b. Hyperglycemia
c. Nervousness
d. Hypotension
e. Weight loss
f. Drowsiness
a. Fragile skin
b. Hyperglycemia
c. Nervousness
A patient is in premature labor. Which of these will be given to accelerate fetal lung maturation?
a. Dexamethasone
b. Betamethasone
c. Hydrocortisone
d. Fludrocortisone
b. Betamethasone
Indications for systemic glucocorticoids include which of these?
a. Cerebral edema
b. Peptic ulcer disease
c. Glaucoma
d. Thyroiditis
e. Spinal cord injury
f. Organ transplantation
a. Cerebral edema
d. Thyroiditis
e. Spinal cord injury
f. Organ transplantation
Because corticosteroids may cause sodium retention, the nurse will closely monitor patients with which condition when administering corticosteroids?
a. Diabetes mellitus
b. Seizure disorders
c. Heart failure
d. Hyperthyroidism
c. Heart failure
The nurse would recognize which potential side effect of glucocorticoid therapy in young children?
a. Arthritis
b. Growth suppression
c. Constipation
d. Iron-deficiency anemia
b. Growth suppression
Which two effects of corticosteroids are the ones most commonly seen in hospitalized patients?
a. Hypoglycemia
b. Hyperglycemia
c. Moon face
d. Fragile skin
e. Psychosis
b. Hyperglycemia
e. Psychosis
To assist in counteracting the adverse effects of glucocorticoid therapy, the nurse would encourage the patient to increase levels of which nutrient in the diet?
a. Vitamin K
b. Vitamin D
c. Magnesium
d. Phosphorou
b. Vitamin D
