Corticosteroids Flashcards
What are exogenous corticosteroids?
Manufactured medications
What does endogenous mean?
Corticosteroids released from the adrenal glands. Made in the body.
Name the types of endogenous corticosteroids.
Glucocorticoids
Mineralocorticoids
Androgens
What do glucocorticoids do in the body?
Regulate protein and fat metabolism Increase blood glucose Buffers the stress response( blocks things that require a lot of energy) Alters immune function Reduces inflammatory response
What is the target hormone of glucocorticoids?
Cortisol
What do mineralocorticoids do?
Regulate sodium, water and potassium balance
What is the target hormone of the mineralocorticoids?
Aldosterone
What do androgens do?
Contribute to growth and development
Sexual activity in adult women
Progesterone
Testosterone in men
What is cushings dz?
Excessive endogenous production of steroid by adrenal gland
What is Addison’s disease?
Body not producing enough corticosteroid. Autoimmune response that destroys the adrenal cortex.
What are the signs and symptoms of cushings dz?
Weight loss Hypovolemia-reduced aldosterone Hypotension Low Na and K+ A/N/V/diarrhea Anemia and fatigue
What is addisonian crisis?
When exogenous corticosteroids are abruptly stopped, hypotension and shock
What is assessed in an addisonian crisis?
- VS especially BP
- S/S fluid volume deficit
- GI distress/wt loss
- Anemia, HCT, fatigue
- Na+, K+ low
what are the side effects of too much steroids?
Mood swings Insomnia GI irritation Na+ and fluid retention Hypokalemia Hyperglycemia/ carbohydrate intolerance Weight gain Decreased ability to fight infection Slow wound healing Osteoporosis
What are signs of long term exogenous corticoid use …looks like cushings dz
Truncal obesity / hyperglycemia Moon face, hirsuitism, acne Thin skin, poor wound healing Sodium and water retention Hypokalemia GI ulcers Osteoporosis Mood swings, fatigue
What assessments are made for a pt on corticosteroids?
Temperature, s/s of infection VS/especially BP Fluid volume excess N/V, gastric upset Hyperglycemia(stress), BG monitoring Wt gain Assess wound healing Osteoporosis Mood changes / emotional effects
What are the therapeutic nursing interventions for pts taking exogenous corticosteroids?
Teach: administer with meals
Continue the dose, and taper. Do not abruptly stop
Low Na diet,
Complex carbohydrates, not simple sugars
Adequate calcium in diet, wtbearing exercises
Vaccination for prevention of infection
Planning/support for possible body image change
Wear medic-alert infor bracelet
Emotional support
What are some common nursing dx for patients with problems related to corticosteroid therapy?
Knowledge deficit( medication regime) r/t
Fluid volume alteration r/t
Risk for infection r/t
Body image disturbance r/t
What are the nursing assessments for Addison’s disease?
VS especially BP S/S fluid volume deficit GI distress/weight loss Anemia/ HCT, fatigue Na+, K+_low
What is done to decrease side effects of steroid use?
Reduction in dose, lowest dose possible
Gradual tapering
Conversion to alternate day routine- allows pituitary to make some ACTH.
Why are corticosteroids given?
Tx illnesses by decreasing the inflammatory response Decreases inflammation -redness -swelling -heat -pain Immunosuppression Hormone replacement in adrenocorticol insufficiency Antineoplastic
What is the action of corticosteroids?
Anti inflammatory
Immunosuppressant
Maintenance of normal BP -aldosterone
Maintenance of normal Glucose metabolism
