Corticosteroids

Question 0

What are exogenous corticosteroids?

Answer 0

Manufactured medications

Question 1

What does endogenous mean?

Answer 1

Corticosteroids released from the adrenal glands. Made in the body.

Question 2

Name the types of endogenous corticosteroids.

Answer 2

Glucocorticoids
Mineralocorticoids
Androgens

Question 3

What do glucocorticoids do in the body?

Answer 3

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

Question 4

What is the target hormone of glucocorticoids?

Answer 4

Cortisol

Question 5

What do mineralocorticoids do?

Answer 5

Regulate sodium, water and potassium balance

Question 6

What is the target hormone of the mineralocorticoids?

Answer 6

Aldosterone

Question 7

What do androgens do?

Answer 7

Contribute to growth and development
Sexual activity in adult women
Progesterone
Testosterone in men

Question 8

What is cushings dz?

Answer 8

Excessive endogenous production of steroid by adrenal gland

Question 9

What is Addison’s disease?

Answer 9

Body not producing enough corticosteroid. Autoimmune response that destroys the adrenal cortex.

Question 10

What are the signs and symptoms of cushings dz?

Answer 10

Weight loss
Hypovolemia-reduced aldosterone
Hypotension
Low Na and K+
A/N/V/diarrhea 
Anemia and fatigue

Question 11

What is addisonian crisis?

Answer 11

When exogenous corticosteroids are abruptly stopped, hypotension and shock

Question 12

What is assessed in an addisonian crisis?

Answer 12

1. VS especially BP
2. S/S fluid volume deficit
3. GI distress/wt loss
4. Anemia, HCT, fatigue
5. Na+, K+ low

Question 13

what are the side effects of too much steroids?

Answer 13

Mood swings
Insomnia
GI irritation
Na+ and fluid retention 
Hypokalemia 
Hyperglycemia/ carbohydrate intolerance
Weight gain 
Decreased ability to fight infection
Slow wound healing
Osteoporosis

Question 14

What are signs of long term exogenous corticoid use …looks like cushings dz

Answer 14

Truncal obesity / hyperglycemia
Moon face, hirsuitism, acne
Thin skin,  poor wound healing
Sodium and water retention
Hypokalemia
GI ulcers
Osteoporosis
Mood swings, fatigue

Question 15

What assessments are made for a pt on corticosteroids?

Answer 15

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

Question 16

What are the therapeutic nursing interventions for pts taking exogenous corticosteroids?

Answer 16

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

Question 17

What are some common nursing dx for patients with problems related to corticosteroid therapy?

Answer 17

Knowledge deficit( medication regime) r/t
Fluid volume alteration r/t
Risk for infection r/t
Body image disturbance r/t

Question 18

What are the nursing assessments for Addison’s disease?

Answer 18

VS especially BP
S/S fluid volume deficit
GI distress/weight loss
Anemia/ HCT, fatigue
Na+, K+_low

Question 19

What is done to decrease side effects of steroid use?

Answer 19

Reduction in dose, lowest dose possible
Gradual tapering
Conversion to alternate day routine- allows pituitary to make some ACTH.

Question 20

Why are corticosteroids given?

Answer 20

Tx illnesses by decreasing the inflammatory response
Decreases inflammation
-redness
-swelling
-heat
-pain
Immunosuppression
Hormone replacement in adrenocorticol insufficiency
Antineoplastic

Question 21

What is the action of corticosteroids?

Answer 21

Anti inflammatory
Immunosuppressant
Maintenance of normal BP -aldosterone
Maintenance of normal Glucose metabolism