A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone) therapy for rheumatoid arthritis. Which information will the nurse include in discharge teaching? (Select all that apply.)
a. "Daily, single dose therapy should be taken in the morning."
b. "The metabolic needs of your body will be increased."
c. "Steroids should never be discontinued abruptly."
d. "Signs and symptoms of infections may not be evident."
e. "Blood glucose levels will be elevated on corticosteroid therapy."
ANS: A, C, D, E
During steroid replacement therapy, the drugs should mimic the body's circadian rhythm. Steroids ordered once a day are given early in the morning. Steroid replacement therapy is gradually tapered in small increments before discontinuation to ensure that the patient's adrenal glands are able to start secreting steroids to compensate for the reduced drug dosage. Glucocorticoids have an anti-inflammatory action and therefore suppress the signs and symptoms of an infection. An adverse effect of glucocorticoid therapy is increased blood sugar levels. Glucocorticoids do not increase the body's metabolic needs.
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