A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?
1. Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
2. Up-regulation decreases the number of receptors on the cell-wall surface.
3. Up-regulation requires time for regrowth of cell-wall hormone receptors.
4. Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.
Correct Answer: 3
Rationale 1: Sensitivity of individual receptors is not an issue.
Rationale 2: Cell-wall receptors do not decrease in number.
Rationale 3: When a hormone that was administered in large doses is discontinued, it takes several days for cells to produce enough protein receptors to capture endogenous hormone. Tapering the dose allows time for the process to finish before the hormone is stopped.
Rationale 4: The shape of the receptors is unchanged.
Global Rationale: When a hormone that was administered in large doses is discontinued, it takes several days for cells to produce enough protein receptors to capture endogenous hormone. Tapering the dose allows time for the process to finish before the hormone is stopped. Sensitivity of individual receptors is not the issue. Cell-wall receptors do not decrease in number and the shape of the receptors is unchanged.
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