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7 Cards in this Set
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A patient has been taking oral prednisone 60 mg daily for three days for an asthma exacerbation, which has resolved. The patient reports having gastrointestinal upset the primary NP should |
Discontinue the prednisone. The patient's asthma symptoms have resolved so the prednisone may be discontinued. If the patient has been on the medication for a few days it is not necessary to taper the dose before the patient stops taking it. Patients required long-term dosing of steroid a PPI could be used. Every other day dosing is used. Alternate day dosing is sometimes used for long-term therapy to minimize suppression of the hypothalamic-pituitary-adrenal axis |
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A patient will require a long course of steroids to treat a chronic inflammatory condition. The primary expects The Specialist to order |
Hydrocortisone every other day. Hydrocortisone is a short-acting glucocorticoid. The use of a short-acting agent and an alternate day dosage regimen should be considered for long-term therapy. Prednisone and triamcinolone are medium acting glucocorticoids. Dexamethasone is a long-acting glucocorticoid |
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A 7 year old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary NP notes a decrease in the Child's growth rate. The NP should consult the child's asthma specialist about |
Giving a double dose of prednisone every other day. Administration of a double dose of a glucocorticoid every other morning has been found to cause less suppression of the HPA axis and less growth suppression in children. Because the child has severe asthma an oral steroid is necessary. Growth hormone therapy is not indicated. Twice-daily dosing would not change the HPA axis suppression |
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A 70 year old patient with COPD who is new to the clinic reports taking 10mg of Prednisone daily for several years. The primary care NP should |
Order a serum glucose, potassium level, and bone density testing . Serum glucose and potassium levels are part of monitoring for side effects of steroids. Because elderly patients are more prone to certain potential catabolic adverse effects of steroid therapy caution is required. Osteoporosis is often seen with elderly patients so bone density testing should be performed. The medication dosing regimen should not be changed unless there is an indication of adverse |
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The primary care NP prescribes an oral steroid to a patient and provides teaching about the medication. Which statement by the patient indicates a need for further teaching? |
I can expect a decreased appetite while I am taking this medication. Therapeutic Administration is least likely to interfere with natural hormone production when the drug is given at the time of natural Peak activity it is generally recommended to administer the full Daily Dose before 9 a.m. oral glucocorticoids usually are given with meals to limit GI irritation common side effects include changes in mood, insomnia, and increase appetite |
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The patient with ulcerative colitis takes 30 mg of methyl prednisone (Medrol) daily. the primary care NP sees this patient for bronchitis and orders azithromycin. The NP should |
Temporarily decrease the dose of methyl prednisone. When given concurrently with macrolide antibiotics, methylprednisolone clearance is reduced so a smaller dose of Methylprednisolone is needed. IM Administration does not affect clearance of the drug. Changing the dose to twice-daily dosing is not recommended. Stopping the drug abruptly is not recommended |
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A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue the primary NP should counsel this patient to |
Increase the dose of prednisolone to the most recent amount taken. Sudden discontinuation or rapid tapering of glucocorticoids in patients who have developed adrenal suppression can precipitate symptoms of adrenal insufficiency, including nausea, weakness, depression, anorexia, myalgia, hypertension, and hypoglycemia. When patients experience these symptoms during a drug taper, the dose should be increased to the last dose. Vitamin D deficiency is common while taking glucocorticoids but these are not symptoms of vitamin D deficiency. Changing to another glucocorticoid is not recommended. Patients should be taught to report the side effects so that action can be taken and should not be told that they are expected |
