prednisone (glucocorticoid)

Question 1

what is the drug class of prednisone

Answer 1

glucocorticoid

Question 2

which route is prednisone administered

Answer 2

oral

Question 3

pharmacological action of prednisone

Answer 3

prevent inflammation; suppress airway mucus production; promote responsiveness of beta 2 receptors in the bronchial tree; reduction in airway mucosa edema

Question 4

what is short term oral therapy used to treat

Answer 4

manifestations following an acute asthma episode

Question 5

what is long term oral therapy used to treat

Answer 5

chronic severe asthma

Question 6

clients can develop complications to prednisone when it is used for ____ days or more

Answer 6

when used for 10 days or more

Question 7

complications of prednisone

Answer 7

suppression of adrenal gland function
bone loss
hyperglycemia and glycosuria
myopathy
peptic ulcer disease
infection fluid and electrolyte disturbance
increased appetite/weight gain
trouble sleeping/insomnia

Question 8

why can suppression of adrenal gland occur with inhaled and oral agents of glucocorticoids

Answer 8

decreases ability of adrenal cortex to produce glucocorticoids

Question 9

nursing interventions for prednisone use

Answer 9

administer oral glucocorticoid on an alternate-day dosing schedule
administer with food or meals
monitor blood glucose levels
taper dose do not stop abruptly
use lowest dose possible to control manifestations
monitor blood glucose levels
clients may need an increase in insulin dosage

Question 10

client education to prevent bone loss while taking prednisone

Answer 10

perform weight bearing exercises
consume with a sufficient calcium and vitamin D intake
report indications of muscle weakness

Question 11

client education on prevention of peptic ulcer disease while on prednisone

Answer 11

avoid NSAIDs
take with food and meals
monitor for black/tarry stools and occult blood

Question 12

client education on prevention of infections while on prednisone

Answer 12

-notify provider of early manifestations of
infections ( sore throat, weakness; malaise)
avoid large crowds if possible
practice hand hygiene

Question 13

client education on prevention of fluid and electrolyte disturbance

Answer 13

observe manifestations of fluid and electrolyte disturbance (weight gain and edema )
hypokalemia ( evidenced by muscle weakness)

Question 14

what are additional adverse effects of prednisone

Answer 14

increased appetite/weight gain
trouble sleep/ insomnia

Question 15

contraindications/precautions of prednisone

Answer 15

pregnancy— use during pregnancy not established
avoid chronic use in lactating patients
clients who have live virus vaccine; systemic fungal infections;

use cautiously in children and patients with diabetes mellitus; hypertension; heart failure; peptic ulcer disease; osteoporosis; kidney dysfunction

Question 16

interactions of prednisone

Answer 16

concurrent use of potassium-depleting diuretics; NSAIDs; glucocorticoids and hypoglycemic agents (oral and insulin)

Question 17

what can concurrent use of prednisone and potassium-depleting diuretics cause

Answer 17

hypokalemia

Question 18

because concurrent use of prednisone and potassium-depleting diuretics can cause hypokalemia what nursing actions should be taken

Answer 18

monitor potassium level and administer supplements as needed

Question 19

what can concurrent use of NSAIDs and prednisone cause

Answer 19

GI ulceration

Question 20

because concurrent use of NSAIDs and prednisone can cause GI ulceration what should you educate the client on

Answer 20

avoid NSAIDs; if GI distress occurs notify the provider

Question 21

because concurrent use of glucocorticoids and hypoglycemic agents (oral and insulin) counteract the effects what should you educate the client on

Answer 21

notify provider if hyperglycemia occurs; increased dosage might be needed of insulin or oral hypoglycemics

Question 22

how often are short term oral glucocorticoids used for

Answer 22

3 to 10 days following an acute asthma exacerbation

Question 23

if a client is on long-term oral therapy when should additional dosages of oral glucocorticoids be required

Answer 23

additional dosage required in times of stress–infection or trauma

Question 24

clients who discontinue oral glucocorticoid medications or switch from oral to inhaled agents require additional doses of oral or IV glucocorticoids during periods of

Answer 24

stress

Question 25

glucocorticoids are not used to treat

Answer 25

an acute episode

Question 26

short term glucocorticoid IV agents are used for

Answer 26

status asthmaticus

Question 27

glucocorticoids can be used to promote what in fetuses at risk for preterm birth

Answer 27

promote lung maturity and decrease respiratory distress