Adverse reactions of prednisone therapy include which of the following conditions?
A. Acne and bleeding gums
B. Sodium retention and constipation
C. Mood swings and increased temperature
D. Increased blood glucose levels and decreased wound healing.
Correct Answer: D. Increased blood glucose levels and decreased wound healing.
Steroid use tends to increase blood glucose levels, particularly in clients with diabetes and borderline diabetes. Steroids also contribute to poor wound healing and may cause acne, mood swings, and sodium and water retention. Adverse effects are common in patients receiving glucocorticoids in high doses or over a long period. Potential adverse effects include skin fragility, weight gain, increased risk of infections, and fractures. Significant cardiovascular and metabolic effects are hypertension, hyperglycemia, and dyslipidemia.
Option A: Steroids don’t affect bleeding tendencies. The primary adverse effects of prednisone include hyperglycemia, insomnia, increased appetite, hypertension, osteoporosis, edema, adrenal suppression, cataracts, and delayed wound healing.
Option B: Steroids don’t affect constipation. Other adverse reactions include adrenal insufficiency, particularly when undergoing stressful procedures or during sepsis; this is typically diagnosable when the patient is hypotensive and not responsive to fluids, vasopressors, or cardiogenic medications.
Option C: Steroids don’t affect thermoregulation. Doctors can opt to track serum glucose, blood pressure, electrolytes, weight, bone mineral density, hemoglobin, occult blood loss, growth in pediatric patients, and infections. The HPA axis suppression should also undergo an assessment by morning cortisol test, adrenocorticotropic hormone stimulation test, and by measuring urinary free cortisol test.
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