The nurse is assisting a client to master the use of a steroid inhaler. The client says, "I don't think I should be using steroids. I see steroids labeled as bad in the news at least once a week." The nurse's response is based on the fact that:

Question

1. The steroid preparations used to treat airway problems are very different from the steroids abused by people reported in the news media.
2. Steroids can be very risky, but the risk is necessary in this client's case.
3. Inhaled steroids are very useful in managing reactive airways, with a fairly good safety profile.
4. Inhaled steroid use is usually short term, so any risk to the client is minimal.

Answer 1

Correct Answer: 3
Rationale 1: Inhaled steroids are very useful in managing reactive airways. The core of all steroid preparations is the same.
Rationale 2: Inhaled steroids are very useful in managing reactive airways, with a fairly good safety profile.
Rationale 3: Inhaled steroids are very useful in the management of chronic diseases like asthma and bronchitis. Because they are inhaled, their desired effect is local. The safety profile is good because the adverse effects are local as well.
Rationale 4: Some clients need to use these drugs long term.
Global Rationale: Corticosteroids decrease inflammation of the airways by inhibiting the synthesis and release of inflammatory mediators, including histamine, leukotriene, cytokines, and prostaglandins. They also inhibit the number of circulating leukocytes and decrease vascular permeability. This results in diminished mucus production and edema, thus reducing airway obstruction. When inhaled on a daily schedule, corticosteroids suppress inflammation without producing major adverse effects. While the core of all steroid preparations is the same, inhaled steroids tend to have a limited, local effect.