The nurse is caring for a client who had been receiving supplemental cortisone. The client developed a bleeding ulcer, and the steroid was discontinued

Question

The bleeding has stopped but the blood pressure remains unstable. The nurse recognizes that the unstable blood pressure is related to:
1. down-regulation of corticosteroid receptors.
2. up-regulation of epinephrine.
3. up-regulation of corticosteroid receptors.
4. down-regulation of epinephrine.

Answer 1

Correct Answer: 1
Rationale 1: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation.
Rationale 2: Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.
Rationale 3: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation. It takes several days for cells to grow enough new receptors to capture all the available endogenous steroid. That process is known as up-regulation.
Rationale 4: Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.
Global Rationale: The client's corticosteroid receptors decreased in number while exogenous steroids were given. This process is known as down-regulation. It takes several days for cells to grow enough new receptors to capture all the available endogenous steroid. That process is known as up-regulation. Epinephrine helps support blood pressure, but its levels are not affected by steroid therapy.