A client on lifelong replacement therapy with hydrocortisone is scheduled for surgery. The nurse anticipates that prior to surgery, the client's hydrocortisone dose will:

Question

1. remain unchanged.
2. be increased.
3. be decreased.
4. be rapidly withdrawn.

Answer 1

Correct Answer: 2
Rationale 1: The dose will not remain unchanged.
Rationale 2: Maintenance dosages of corticosteroids for adrenal insufficiency need to be increased during times of infection, surgery, or injury to adapt to the increased stress.
Rationale 3: The dose will not be decreased.
Rationale 4: Steroid therapy should never be rapidly withdrawn because an adrenal crisis could occur.
Global Rationale: Maintenance dosages of corticosteroids for adrenal insufficiency need to be increased during times of infection, surgery, or injury to adapt to the increased stress. Steroid therapy should never be rapidly withdrawn because an adrenal crisis could occur.