Question

Aassignment chapter 36, Andrenocortical Agents

Learning Objective(s) Group Assignment(s) 1. Corticosteroids have many adverse reactions. Prepare a list of adverse reactions. For each adverse reaction, determine nursing assessments or nursing measures essential to monitoring the adverse reaction or to treating the adverse reaction. What is the rationale for each assessment or nursing measure? 2. Develop a teaching plan for an adult patient prescribed prednisone for an exacerbation of rheumatoid arthritis. What are the most essential teaching points to stress to patients taking prednisone?

Answer 1

Adverse effect Increased risk of infection Hyperglycemia Hypertension Osteoporosis Hypercholestrolemia

Nursing intervention Teach good hand hygiene Monitor temperature daily Avoid exposure to infections. Provide immunization against infectious disease Encourage a well balanced, low calorie diet. Weigh patient weekly Check blood sugar level Avoid sugar rich food Food rich in salts should be avoided Processed food, pickle high in sodium should be avoided. Avoid the drug such as antacids which high in sodium should be avoided Encourage to eat calcium, low fat diet Administration of calcium and vitamin D3supplement Encourage moderately exercise Monitor lipid profile

Rationale To reduce infection To get baseline data To protect from infection To protect from infection. To prevent hyperglycemia To get baseline data To identify hyperglycemia Salt increase blood pressure Sodium increase blood pressure To prevent osteoporosis. It reduce the risk of development of osteoporosis To get base line data

Long term use of prednisone causes side effects. So regular blood check up to monitor complications. Blood sugar level, calcium, serum electrolyte, lipid profile etc.

• Balanced diet
• The above mentioned( table )are included in teaching plan.