A client on long-term corticosteroid therapy is demonstrating signs of acute adrenocortical insufficiency. The nurse knows that these symptoms are caused by:
Standard Text: Select all that apply.
1. the shutting down of ACTH secretion.
2. the failure of the adrenal cortex to secrete corticosteroids.
3. rebound ACTH secretion.
4. excessive secretion of ACTH.
5. toxic levels of mineralocorticoids.
Correct Answer: 1,2
Rationale 1: Consistent high amounts of corticosteroid medications provide continuous negative feedback to the hypothalamus and pituitary, shutting down the secretion of ACTH.
Rationale 2: Without stimulation by ACTH, the adrenal cortex shrinks and stops secreting endogenous corticosteroids.
Rationale 3: Acute adrenocortical insufficiency is not caused by rebound ACTH secretion.
Rationale 4: Acute adrenocortical insufficiency is not caused by excessive secretion of ACTH.
Rationale 5: Mineralocorticoids do not cause acute adrenal insufficiency.
Global Rationale: Consistent high amounts of corticosteroid medications provide continuous negative feedback to the hypothalamus and pituitary, shutting down the secretion of ACTH. Without stimulation by ACTH, the adrenal cortex shrinks and stops secreting endogenous corticosteroids. Acute adrenocortical insufficiency is not caused by rebound ACTH secretion, by excessive secretion of ACTH, or by mineralocorticoid levels.
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