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18 Cards in this Set
- Front
- Back
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Corticosteriods Overview?
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-produce at adrenal cortex
-affects almost all body organs -plays a major role in maintaining hemeostasis -Hypothalamus controls secretion (anterior pituritary & adrenal cortex) |
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Glucocorticoids overview?
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-include cortisol, corticosterone, cortisone
-Cortisol 95 % activity -Secreted cyclically (largest amount in AM, least amount PM |
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Mineralcorticoids overview?
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-Maintain fluid and electrolyte balance
through salt & water metabolism - Aldosterone major mineralcorticoid - Adrenal Sex Hormones |
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Corticosteriods Indications & Usage?
# 1 |
1. Adrenal insufficiency (Long term Replacement)
a. give am or divide 2/3 in am and 1/3 PM b. increase during stress (illness,trauma, surgery, etc) c. wear medical alert bracelet d. Monitor closely for adverse effects |
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Corticosteriods Indications & Usage?
# 2,3,4 |
2. Allergic disorder:
hypersensitivity disorders - allergic reactions to drugs, blood transfusions 3. Collagen disorders -SLE, Scleroderma 4. Dermatologic disorders -Acute contact dermatitis, hepers zoster, skin rashes, Erythema multiforme |
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Corticosteriods Indications & Usage?
# 5,6,7,8 |
5. Gastrointestinal Disorders
-ulcerative colitis, chohn's disease 6. Hematologic disorders -ITP, hemolytic anemia 7. Hepatic disorders -cirrhosis 8 Neoplastic Disease -ALL, CLL, Hodgkin's, Lymphona, Multiple Myeloma |
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Corticosteriods Indications & Usage?
# 9,10,11,12 |
9. Neurologic Conditions
-Cerebral Edema, Brain tumors, Myasthenia gravis, acute spinal cord injury 10. Opthalmic disorders: -Optic neuritis, Sympathetic opthalmia 11. Renal disorders -nephrotic syndrome 12. Respiratory disorders? - Asthma, COPD, Rhinitis, Status asthmaticus |
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Corticosteriods Indications & Usage?
# 13,14,15 |
13. Rheumatic disorders
-RA, Osteoarthritis, Bursitis, Gouty arthritis, 14. Addisonian crisis 15. Suppression of immune response to organ & tissue transplants & grafts |
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Corticosteriods Short term Usage?
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1. acute exacerbations & to adjunct other therapies
2. When acute give IV, switch to PO MUST GRADUALLY WEAN D/C EARLY |
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Corticosteriods Contraindications?
3 |
1. systemic fungal infection
2. hypersensativity of drug 3. Use cautiously with pt with infections, diabetes, peptic ulcer disease, IBD, HTN, CHF & renal insufficiency |
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Corticosteriods
NURSING INTERVENTIONS # 1- 4 |
1. Protect Pt from infection
(aseptic technique, handwashing, dressing changes, limit exposure with sick people, protective isolation if necessary, MONITOR WBC, TEMP) 2. Encourage activity (ROM, Walking, turn and positioning Q2h) 3. Monitor BS Q6H 4. Monitor Vitals Signs (BP) |
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Corticosteriods
NURSING INTERVENTIONS # 5-8 |
5. Monitor Edema & Weight gain
6. Monitor daily electrolytes (K, NA, cardiac arrythmias) 7. Monitor Dietary Intake Low Na, High K, high protein diet, calcium & vitamin D supplements 8 Meds to treat/ prevent side effects (PPI, insulin) |
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Corticosteriods
NURSING INTERVENTIONS # 9-13 |
9. Monitor psychological status
10. Monitor eye for cateracts or glucoma 11. Avoid stressful situations 12. Avoid fatigue 14. Patient Education |
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ADVERSE REACTIONS (I.E)
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-insomnia
-increase NA and H20 retention -Increase K excretion -Supressed immune and inflammatory response - osteoporosis -intestinal perforation -peptic ulcers -impaired wound healing |
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ENDOCRINE SYSTEM REACTIONS (I.E)
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- DM
-Hyperlipidemia -adrenal atrophy - Cushingoid signs and symptoms (such as buffalo humps, moon face, and elevated blood glucose levels). |
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NURSING INTERVENTIONS (I.E)
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-Baseline BP, Fluid & Electrolytes & weight, Reassess regularly
- Depression (high doses) - Glucose - Stress levels |
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KEY NURSING DX (I.E)
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-Risk for infection r/t immunosuppression
-Excess fluid volume -Disturbed body image -imbalanced nutrition; more than body requirements -imbalanced nutrition; less than body requirements - Risk for injury, impaired skin integrity, - ineffective coping - knowledge decifit |
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ABRUPT WITHDRAWAL (I.E)
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-Rebound inflammation
-fatigue, weakness -fever -dizziness -lethargy -depression -fainting -orthostatic hypotension -dyspnea -anorexia -hypoglycemia -ACUTE ADRENAL INSUFFICIENCY CAN BE FATAL |
