RN Nursing · Adverse Effects, Interactions, and Contraindications · Practice question
A patient is prescribed steroids for the treatment of a chronic inflammatory condition. Which of the following side effects should the nurse include in the education of the patient regarding steroid use? Select all that apply.
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Hyperglycemia
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Bronchospasm
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Gastrointestinal bleeding
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Insomnia
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Muscle weakness
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Weight gain
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Osteoporosis
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Blurred vision
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Hypotension
Answer & explanation
Correct: Hyperglycemia · Gastrointestinal bleeding · Insomnia · Muscle weakness · Weight gain · Osteoporosis · Blurred vision
Long-term corticosteroid therapy carries well-known adverse effects. Glucocorticoids antagonize insulin causing hyperglycemia; they reduce gastric mucosal protection leading to GI bleeding/ulcers; CNS stimulation produces insomnia and mood changes; protein catabolism causes muscle weakness/wasting; fluid retention and altered fat distribution lead to weight gain and cushingoid features; bone resorption causes osteoporosis; cataracts and increased intraocular pressure cause blurred vision. Corticosteroids cause hypertension (not hypotension) due to mineralocorticoid effects, and they treat—rather than cause—bronchospasm. Patients require teaching on tapering, infection precautions, and monitoring (Lehne's Pharmacology).
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