Glucocorticoids

Question 1

Medications

Answer 1

• Betamethasone
• Budesonide
• Cortisone
• Dexamethasone
• Hydrocortisone
• Methylprednisolone
• Prednisolone
• Prenisone

Question 2

Actions

Answer 2

• Enter target cells and bind to cytoplasmic receptors
• Initiate many complex reactions responsible for anti-inflammatory and immuno-suppressive effects
• Hydrocortisone, cortisone, and prednisone have some mineralcorticoid acitivty

Question 3

Indications

Answer 3

• Short-term treatment of many inflammatory disorders
• To relieve discomfort
• To give the body a chance to heal from the effects of inflammation

Question 4

Contraindications

Answer 4

• Allergy
• Acute infection
• Pregancy/lactation

Question 5

Caution

Answer 5

• Diabetes (glucose release)

- Peptic ulcer disease

Question 6

Adverse effects

Answer 6

-Headache, insomnia, psychosis, GI upset, HF, fluid retention, increased blood glucose, osteoporosis, frail skin, growth retardation, diabetes, cushing syndrome, impaired wound healing, masking of infections

Question 7

Drug- drug

Answer 7

• Increase in drug when given with erythromycin, ketoconazole, or troleandomycin
• Decrease in drug when given with salicylates, barbiturates, phenotoin, or rifampin

Question 8

Assessment

Answer 8

• History: Allergies, acute infections, contraindications or cautions, endocrine disturbances, and renal dysfunction
• Physical: VS, orientation and affect, eye examination, peripheral perfusion
• Labs: glucose, renal fx electrolytes, endocrine function tests

Question 9

Nursing Diagnoses

Answer 9

• Altered cardiac output r/t fluid retention
• Excess fluid volume r/t water retention
• Disturbed sensory perception
• Risk for infection r/t immunosuppression
• Ineffective coping r/t body changes
• Deficient knowledge
• Imbalanced nutrition

Question 10

Implementation

Answer 10

• Administer drug daily at 8-9 am
• Space multiple doses evenly throughout the day
• Use the minimal dose for the minimal time
• Taper doses when discontinuing
• Arrange for increased dose when under stress
• Do not give live virus vaccines
• Protect from exposure to infection
• Pt teaching

Question 11

Evaluation

Answer 11

• -Monitor patient response
• Evaluate the effectiveness of the teaching plan
• Evaluate the effectiveness of comfort measures
• Evaluate patient compliance with the regimen