A child will require lifelong cortisol replacement therapy following the removal of adrenal glands. Which is the priority instruction for the family?
1. To discontinue the injections after 1 week
2. That hydrocortisone is available only in oral form, so the medication will need to be held if the child has nausea or vomiting
3. To take the hydrocortisone on an empty stomach
4. To administer the medication early in the morning or every other day in the morning
4
Rationale:
1. The injections should not be discontinued abruptly.
2. Injectable hydrocortisone is available, and should be kept on hand if the child is unable to take the medication by mouth.
3. Cortisone should be taken with food.
4. Administering the medication early in the morning or every other day causes fewer symptoms and mimics the normal diurnal pattern of cortisol secretion.
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