A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?
a. "I should reduce the dose by half each day until I stop taking the drug."
b. "I will need to have cortisol levels moni-tored during the withdrawal process."
c. "The withdrawal schedule may take sev-eral months."
d. "If I have surgery, I may need to take the drug for a while, even after I have stopped."
A
Glucocorticoid therapy can suppress adrenal function, so withdrawal should be done slowly to allow recovery of adrenal function. Reducing the dose of a glucocorticoid by half each day is not recommended. Patients should have their cortisol levels monitored to determine when therapy can be stopped. The withdrawal schedule may take several months. Patients who have stopped the drug may still experience adrenal insufficiency in times of physiologic stress, such as surgery.
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