A three-year-old child was born with congenital adrenal insufficiency and is being treated with oral hydrocortisone. When the child develops pneumonia and is admitted to the hospital, the nurse would expect the dose of hydrocortisone to be:
1. Stopped.
2. Reduced by 50%.
3. Continued as previously prescribed.
4. Increased.
4
Rationale 1: Hydrocortisone is the glucocorticoid that helps the body deal with stress. It would be inappropriate to stop the medication.
Rationale 2: The drug dosage would not be decreased.
Rationale 3: During periods of stress, the child will need additional corticosteroids.
Rationale 4: During periods of stress including illness and surgery, the dose of steroids needs to be increased.
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