Addison’s quiz to change

The nurse recognizes that the physical changes due to steroid therapy have affected the body image of the client and it appears that the client wants to stop steroid therapy. What are the direct potential consequences of stopping steroids abruptly?

A 59-year-old male client is admitted with emphysema exacerbation.  The client is on oxygen 2L nasal cannula at home.  The client has a history of CHF, DM, and CKD stage 4. Home medications include: ipratropium-albuterol inhaler, beclamethasone inhaler, oral dexamethasone for the last 6 months, digoxin, captopril, and furosemide.

Client is alert, oriented, and restless. Noted truncal obesity with supraclavicular fat pads, thin extremities, and barrel chest. Bruising noted to both arms and straiae over trunk and thighs. Lungs diminished in all fields. Client states that he is having difficult breathing and is using pursed-lip breathing.  S1, S2 present, no additional heart sounds. No peripheral edema.  BS present x 4 quadrants. Abdomen soft.

The client is non-compliant and has not been taking inhalers as prescribed.

Temp: 98.6º F,  BP 168/55,  HR 89,   RR 24 BPM, Oxygen saturation on 2L NC 90%.

Admission Labs:

• Sodium 144 mEq/L (135-145 mEq/L)
• Potassium 3.6 mEq/L (3.5-5 mEq/L
• Chloride 105 mEq/L (96-106 mEq/L)
• Blood Urea Nitrogen 20 mg/dl (7-20 mg/dl)
• Creatinine 1.3 mg/dl (0.7-1.3 mg/dl)
• Blood Sugar 289 mg/dl (100-125 mg/dl)

The physician has diagnosed the client with iatrogenic Cushing Syndrome.

Type an X to indicate whether each physical change, sign, or symptom listed below supports either COPD or Cushing Syndrome or both.

A 59-year-old male client is admitted with COPD exacerbation.  The client is on oxygen 2L nasal cannula at home.  The client has a history of CHF, DM, and CKD stage 4. Home medications include: ipratropium-albuterol inhaler, beclamethasone inhaler, oral dexamethasone for the last 6 months, digoxin, captopril, and furosemide.

Client is alert, oriented, and restless. noted truncal obesity with supraclavicular fat pads, thin extremities, and barrel chest. Bruising noted to both arms and straiae over trunk and thighs. Lungs diminished in all fields.  Client states that he is having difficult breathing and is using pursed-lip breathing. S1, S2 present, no additional heart sounds. No peripheral edema.  BS present x 4 quadrants.

The client has been non-compliant and has not been taking his inhalers as prescribed.

Temp: 98.6º F,  BP 168/55,  HR 89,  RR 24 BPM,  Oxygen saturation on 2L NC 90%.

Admission Labs:

• Sodium 144 mEq/L (135-145 mEq/L)
• Potassium 3.6 mEq/L (3.5-5 mEq/L
• Chloride 105 mEq/L (96-106 mEq/L)
• Blood Urea Nitrogen 20 mg/dl (7-20 mg/dl)
• Creatinine 1.3 mg/dl (0.7-1.3 mg/dl)
• Blood Sugar 289 mg/dl (100-125 mg/dl)

The client stabilizes and is ready for discharge after receiving inhaled medications as prescribed.  The client expresses concerns about his appearance to the nurse.  The physician changes Dexamethasone to prednisone on alternative days.

The nurse recognizes that the physician has changed dexamethasone to prednisone on alternative days because:

• Sodium 144 mEq/L (135-145 mEq/L)
• Potassium 3.6 mEq/L (3.5-5 mEq/L
• Chloride 105 mEq/L (96-106 mEq/L)
• Blood Urea Nitrogen 20 mg/dl (7-20 mg/dl)
• Creatinine 1.3 mg/dl (0.7-1.3 mg/dl)
• Blood Sugar 289 mg/dl (100-125 mg/dl)

Based on the client’s laboratory results, the nurses recognizes that dexamethasone has

Which of the following statements by a client who is on long-term prednisone requires follow up by the nurse?

Select all that apply.

The nurse has prepared a teaching plan for the client who will be discharged on prednisone. 

For each of the statements made by the client, type an X to specify whether the statement indicates Understanding or No Understanding of the teaching provided. 

Let’s review! Click on what is true of prednisone

A client is admitted with adrenal crisis and is started on methylprednisolone IV.  Which of the following is an expected outcome of methylprednisolone therapy?

The nurse is developing a teaching plan for a client with Addison Disease who will be discharged on Cortisone po daily.  Which of the following teaching points should the nurse include?

Which of the following statements by a client with Addison disease indicates a need for further education?

The nurse has taken care of a client admitted with adrenal crisis for 3 days in a row.  The client is on IV Methylprednisolone.  Which of the following findings indicates that the client’s condition has improved?

The nurse is caring for a client with an Addisonian crisis.  Which of the following interventions should the nurse implement?  

A client is educating a client with Addison Disease about the best diet to follow.  Which of the following diets should the nurse recommend?

The nurse is caring for a client with Addison Disease.  Which of the following physical findings does the nurse anticipate?

The nurse is caring for a client with excess adrenocorticoid activity.  Which of the following physical symptoms should the nurse anticipate? Select all that apply.