A nurse is caring for a client who was prescribed high-dose corticosteroid therapy for 1 month to treat a severe inflammatory condition. The client's symptoms have now resolved and the client asks, "When can I stop taking these medications?"
How should the nurse respond?
a.
"It is possible for the inflammation to recur if you stop the medication."
b.
"Once you start corticosteroids, you have to be weaned off them."
c.
"You must decrease the dose slowly so your hormones will work again."
d.
"The drug suppresses your immune system, which must be built back up."
ANS: B
One of the most common causes of adrenal insufficiency, a life-threatening problem, is the sudden cessation of long-term, high-dose corticosteroid therapy. This therapy suppresses the hypothalamic-pituitary-adrenal axis and must be withdrawn gradually to allow for pituitary production of adrenocorticotropic hormone and adrenal production of cortisol. Decreasing hormone therapy slowly ensures self-production of hormone, not hormone effectiveness. Building the client's immune system and rebound inflammation are not concerns related to stopping high-dose corticosteroids.
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