17-OHCS, 17-KS, PBIFalse negative: Skin allergy testsNURSING CONSIDERATIONSAssess:•K, blood sugar, urine glucose while on long-term therapy; hypokalemia and hyperglycemia•Weight daily; notify physician if weekly gain *5 lb•B/P q4h, pulse; notify physician if chest pain occurs•I&O ratio; be alert for decreasing urinary output and increasing edema•Plasma cortisol levels during long-term therapy (normal level: 138-635 nmol/L SI units when drawn at 8 AM)•Infection: increased temperature, WBC, even after withdrawal of medication; drug masks infection symptoms•K depletion: paresthesias, fatigue, nausea, vomiting, depression, polyuria, dysrhythmias, weakness•Edema, hypertension, cardiac symptoms•Mental status: affect, mood, behavioral changes, aggressionAdminister:•After shaking suspension (parenteral)•Titrated dose; use lowest effective dose•IM injection deeply in large mass; rotate sites; avoid deltoid; use 21G needle•In one dose in AM to prevent adrenal suppression; avoid SC administration; may damage tissue•With food or milk to decrease GI symptomsPerform/provide:•Assistance with ambulation in patient with bone tissue disease to prevent fracturesEvaluate:•Therapeutic response: ease of respirations, decreased inflammationTeach patient/family:•That ID as steroid user should be carried•To notify physician if therapeutic response decreases; dosage adjustment may be needed•Not to discontinue this medication abruptly; adrenal crisis can result•To avoid OTC products: salicylates, alcohol in cough products, cold preparations unless directed by physician•About cushingoid symptomsSymptoms of adrenal insufficiency: nausea, anorexia, fatigue, dizziness, dyspnea, weakness, joint pain HOLISTIC HUMAN RESPONSES/FunctionalDevelopmentalPhysiologicalPsychologicalDimensionsCognitiveEmotionalSelf-ConceptualWellness & Well-being Relative...
