A patient who has been newly diagnosed with adrenal hormone deficiency will begin taking hydrocortisone. The nurse provides teaching for this patient. Which statement by the patient in-dicates understanding of the teaching?
a. "I may take all of my daily dose in the morning or divide it in half and take it twice daily."
b. "I will need to take this medication until my symptoms completely clear, and then I may stop."
c. "Side effects are common with hydrocor-tisone, even with therapeutic doses."
d. "When I am sick, I should take three times the normal dose for 3 days in a row."
D
Patients who take hydrocortisone as replacement need to be taught to increase their daily dose during times of stress, because the drug causes adrenal suppression, and the adrenals will not be able to release cortisone as usual during stress. A general rule of thumb is the "3 by 3 rule": take 3 times the usual dose for 3 days when sick. The daily dose is usually given once in the morning; if late-day fatigue occurs, patients may split the dose and take two-thirds in the morning and one-third in the late afternoon or evening. Treatment is lifetime. Side effects are uncommon when hydrocortisone is given in therapeutic doses.
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