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Prednisone nursing implications
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prednisone Nursing Considerations & Management - RNpedia.Corticosteroids: implications for nursing practice
Nursing Interventions for Corticosteroids. To confirm the indication for administering corticosteroids. Previous allergic reaction to corticosteroids may render the patient unable to take them. Alternatives to corticosteroids should therefore be considered in case of allergy. Assess if the patient is pregnant or lactating. Very potent corticosteroids should be prescribed in caution to a pregnant woman or lactating mother as these drugs can potentially harm the fetus or newborn.
To check for any potential problems with administration, hydration, and absorption. To ensure that the right form of corticosteroids is given through the right route. Check for current medications that include diuretics, laxatives, high doses of certain antibiotics and insulin as these should be used cautiously with corticosteroids. An increased risk of hypokalemia may occur when corticosteroids are administered with other medications that reduce potassium levels like diuretics , laxatives, high doses of certain antibiotics and insulin.
Check medical history for diabetes or myasthenia gravis. Corticosteroids can increase serum glucose levels. Corticosteroids given with anticholinesterase can cause severe weakness in individuals diagnosed with myasthenia gravis.
Administer corticosteroids in the morning with breakfast. To ensure optimal absorption and therapeutic action by corticosteroids. Educate the patient about the action, indication, common side effects, and adverse reactions to note when taking corticosteroids.
Instruct the patient on how to self-administer corticosteroids. For topical steroids, advise the lactating mother to wash off any steroid cream from the skin prior to feeding the baby.
To ensure that the steroid is not ingested by the baby during breastfeeding. Inform the patient not to have any live vaccine within 3 months after the course of corticosteroids. Corticosteroids may weaken the immune system. Taking NSAIDs and steroids may increase the risk for internal gastrointestinal bleeding and stomach ulcers.
Advise the patient to rinse the mouth with water after using steroid inhalers. Advise the patient to eat moderately while on steroids, especially when taking it for more than 3 weeks. Taking corticosteroids for less than 3 weeks poses little to no side effects. However, taking steroids for more than 3 weeks may increase appetite, leading to weight gain. Towards the end of the course of corticosteroids, inform the patient if the steroids need to be tapered down.
Abruptly stopping some types of steroids such as prednisone may cause withdrawal symptoms such as fatigue, joint pain, lightheadedness, and dizziness. Routinely check for the blood glucose level of the patient, especially if they are diabetic.
Ask the patient to repeat the information about corticosteroids. To evaluate the effectiveness of health teaching on corticosteroids. To ensure that the corticosteroids did not cause any electrolyte imbalance particularly hypokalemia or renal dysfunction. To treat inflammatory pulmonary condition e. To treat renal conditions such as nephrotic syndrome. To treat certain rheumatologic conditions, such as acute gouty arthritis, psoriatic arthritis, relapsing polychondritis, rheumatoid arthritis.
To treat severe infectious diseases, such as trichinosis with neurologic or myocardial involvement, tuberculous meningitis. Off-label uses include prevention of post-therapeutic neuralgia, acute pain relief from herpes zoster, autoimmune hepatitis. What are the contraindications of prednisone? The contraindications of prednisone are: Hypersensitivity to prednisone or its components Fungal infections Psychosis Peptic ulcer Caution: DM, renal disease, HF, MI , hypertension, osteoporosis; seizures , cataracts, glaucoma.
Prednisone Interactions Drug interactions Prednisone along with Aminoglutiamide causes corticosteroid-induced adrenal suppression Prednisone metabolism increases with CYP3A4 inducers such as barbiturates, phenytoin, carbamazepine, rifampin.
Prednisone metabolism decreases with CYP3A4 inhibitors such as ketoconazole, macrolide antibiotics Cholestyramine increases prednisone clearance. Prednisone with digoxin increases risk of arrythmias and digitalis toxicity due to hypokalemia. Live vaccine with prednisone may lead to loss of antibody response and increased risk of neurologic complications. Corticosteroids increases blood glucose levels; therefore, insulin and oral antidiabetic dose needs to be adjusted accordingly.
Prednisone may decrease the effectiveness of warfarin. Prednisone reduces blood isoniazid levels. Parental administration of Amphotericin B with corticosteroids can cause cardiomegaly and congestive heart failure. Concomitant use of corticosteroids with anticholinesterase agents may cause severe weakness in patients with myasthenia gravis.
Alcohol, salicylates, cyclosporine, and diuretics increase the adverse effects of prednisone. Lab interactions Prednisone increases serum cholesterol, serum sodium, blood glucose, uric acid, urine glucose. Prednisone may induce false-negative result in skin allergy tests. Echinacea and ephedra ma huang may decrease therapeutic effectives of prednisone.
What are prednisone side effects? Prednisone Nursing Implications [Nursing Considerations] Prednisone nursing considerations are divided into nursing assessment, interventions, and evaluation. Prednisone Nursing Assessment Obtain comprehensive medical and psychiatric history. Monitor vital signs and body weight. Assess for the signs of infection such as oral Candida infection. Monitor regularly for signs and symptoms of heart failure and hypertension because prednisone can produce many adverse reactions.
Monitor intake and output. Watch for decreased urine output, increased edema, rales, and crackles. Measure daily weight. Notify prescriber if weight gain is more than 5 lbs per week. Monitor growth pattern in children. Prednisone may cause growth retardation. Monitor for hypothalamic-pituitary-adrenal suppression caused by prolonged use of prednisone.
Periodically monitor serum potassium, blood glucose, WBC, urine glucose, plasma cortisol during long-term therapy. Periodically reassess the mental status affect, mood, behavioral changes, aggression, hallucination. For decreased inflammation and immune responses to autoimmune disorders, allergic reactions, and neoplasms. For ease of respiration. It is also linked to an increased incidence of fetal cleft palate, especially when taken during the first trimester.
Prednisone should be used with caution during pregnancy only if benefit to mother outweighs potential risk to fetus. Monitor the newborn for hypoadrenalism, if mother has received corticosteroid therapy during pregnancy. Consult with the physician before lactation since corticosteroid is excreted in breast.
High doses for corticosteroid could interfere with endogenous corticosteroid production, suppress growth, or cause other adverse effects in the breastfed infant.
What are the nurse patient teachings for prednisone? The prednisone nurse teaching for patients should include the following points.
To decrease gastrointestinal irritation, instruct the patient to take prednisone with food in the morning as prescribed. Instruct the patient not to break, divide, or chew delayed-release tablet form because the delayed-release action is dependent on an intact coating.
Teach the adverse effects of abruptly discontinuing therapy.
Also, its dosage, indication, side effects. Nursing implications include nursing assessment, nursing intervention, nursing diagnosis, and evaluation for prednisone. Children: PO: 0. Absorption: Prednisone is effectively absorbed from the GI tract when taken orally. Prednisone inhibits inflammatory and immunological responses by binding to intracellular glucocorticoid receptors and acting through the following mechanisms:.
Prednisone nursing considerations are divided into nursing assessment, interventions, and evaluation. You learned about prednisone nursing implications and patient teachings in this article. Kee, J. Kizior, R. Elsevier Inc. All the contents on this site are for entertainment, informational, educational, and example purposes ONLY.
These contents are not intended to be used as a substitute for professional medical advice or practice guidelines. However, we aim to publish precise and current information. By using any content on this website, you agree never to hold us legally liable for damages, harm, loss, or misinformation. Read the privacy policy and terms and conditions. Privacy Policy. All rights reserved. Children: 0. Metabolism: Hepatic. Half-life: 2. Excretion: Primarily excreted via urine.
Prednisone Mechanism of Action Prednisone inhibits inflammatory and immunological responses by binding to intracellular glucocorticoid receptors and acting through the following mechanisms: Inhibiting neutrophil and monocyte accumulation, as well as their phagocytic and bactericidal activities, are suppressed at the site of inflammation. Stabilization of the lysosomal membrane. Inhibiting macrophage and helper T cell antigen response Suppressing the production of inflammatory response mediators such cytokines, interleukins, and prostaglandins.
Therapeutic effects of prednisone: Prevents or hinders cell-mediated immune responses. Lower or blocks tissue reactivity to the inflammatory process. What are the indications of prednisone? Prednisone indications include: To treat allergic conditions e.
To treat endocrine disorders, such as congenital adrenal hyperplasia, hypercalcemia of malignancy, nonsuppurative thyroiditis.
To treat acute episodes of ulcerative colitis. To treat hematologic diseases, such as acquired autoimmune hemolytic anemia, Diamond—Blackfan anemia DBApure red cell aplasia. To treat neoplastic conditions, such as acute leukemia, aggressive lymphomas.
To treat certain ophthalmic conditions e. After organ transplant to prevent organ rejection. To treat inflammatory pulmonary condition e.
To treat renal conditions such as nephrotic syndrome. To treat certain rheumatologic conditions, such as acute gouty arthritis, psoriatic arthritis, relapsing polychondritis, rheumatoid arthritis.
To treat severe infectious diseases, such as trichinosis with neurologic or myocardial involvement, tuberculous meningitis. Off-label uses include prevention of post-therapeutic neuralgia, acute pain relief from herpes zoster, autoimmune hepatitis.
What are the contraindications of prednisone? The contraindications of prednisone are: Hypersensitivity to prednisone or its components Fungal infections Psychosis Peptic ulcer Caution: DM, renal disease, HF, MIhypertension, osteoporosis; seizurescataracts, glaucoma. Prednisone Interactions Drug interactions Prednisone along with Aminoglutiamide causes corticosteroid-induced adrenal suppression Prednisone metabolism increases with CYP3A4 inducers such as barbiturates, phenytoin, carbamazepine, rifampin.
Prednisone metabolism decreases with CYP3A4 inhibitors such as ketoconazole, macrolide antibiotics Cholestyramine increases prednisone clearance.
Prednisone with digoxin increases risk of arrythmias and digitalis toxicity due to hypokalemia. Live vaccine with prednisone may lead to loss of antibody response and increased risk of neurologic complications. Corticosteroids increases blood glucose levels; therefore, insulin and oral antidiabetic dose needs to be adjusted accordingly.
Prednisone may decrease the effectiveness of warfarin. Prednisone reduces blood isoniazid levels. Parental administration of Amphotericin B with corticosteroids can cause cardiomegaly and congestive heart failure.
Concomitant use of corticosteroids with anticholinesterase agents may cause severe weakness in patients with myasthenia gravis. Alcohol, salicylates, cyclosporine, and diuretics increase the adverse effects of prednisone.
Lab interactions Prednisone increases serum cholesterol, serum sodium, blood glucose, uric acid, urine glucose. Prednisone may induce false-negative result in skin allergy tests. Echinacea and ephedra ma huang may decrease therapeutic effectives of prednisone. What are prednisone side effects? Prednisone Nursing Implications [Nursing Considerations] Prednisone nursing considerations are divided into nursing assessment, interventions, and evaluation.
Prednisone Nursing Assessment Obtain comprehensive medical and psychiatric history. Monitor vital signs and body weight. Assess for the signs of infection such as oral Candida infection. Monitor regularly for signs and symptoms of heart failure and hypertension because prednisone can produce many adverse reactions. Monitor intake and output. Watch for decreased urine output, increased edema, rales, and crackles. Measure daily weight. Notify prescriber if weight gain is more than 5 lbs per week.
Monitor growth pattern in children. Prednisone may cause growth retardation. Monitor for hypothalamic-pituitary-adrenal suppression caused by prolonged use of prednisone. Periodically monitor serum potassium, blood glucose, WBC, urine glucose, plasma cortisol during long-term therapy. Periodically reassess the mental status affect, mood, behavioral changes, aggression, hallucination.
For decreased inflammation and immune responses to autoimmune disorders, allergic reactions, and neoplasms. For ease of respiration. It is also linked to an increased incidence of fetal cleft palate, especially when taken during the first trimester. Prednisone should be used with caution during pregnancy only if benefit to mother outweighs potential risk to fetus. Monitor the newborn for hypoadrenalism, if mother has received corticosteroid therapy during pregnancy.
Consult with the physician before lactation since corticosteroid is excreted in breast. High doses for corticosteroid could interfere with endogenous corticosteroid production, suppress growth, or cause other adverse effects in the breastfed infant.
What are the nurse patient teachings for prednisone? The prednisone nurse teaching for patients should include the following points. To decrease gastrointestinal irritation, instruct the patient to take prednisone with food in the morning as prescribed. Instruct the patient not to break, divide, or chew delayed-release tablet form because the delayed-release action is dependent on an intact coating.
Teach the adverse effects of abruptly discontinuing therapy. Encourage patient to stop alcohol consumption during therapy. Because it increases risk of gastrointestinal ulcers, bleeding, and delirium. Instruct the patient to notify prescriber immediately about possible exposure to measles or chickenpox. And to seek medical attention immediately in case of severe abdominal pain or tarry stools. Also, to notify prescriber about visual disturbances, swelling, weight gain, tiredness, bone pain, bruising, nonhealing wounds, or r behavior changes.
Tell the patient to avoid vaccination during corticosteroid therapy without consulting with the prescriber. Teach diabetic patients to regularly monitor their blood glucose levels because corticosteroids are associated with hyperglycemia.
And anti-diabetic drug doses may need to be increased. Encourage the patients on long-term corticosteroid therapy to take a high-protein, calcium-and-potassium-rich diet that is low in salt and carbohydrates.
Advise the patient to carry emergency ID information about product taken and condition as corticosteroid user. Tell the patient to report signs of infection or injury for up to 12 months after therapy.
Conclusion You learned about prednisone nursing implications and patient teachings in this article. Skidmore-Roth, L. Sharing is Caring:.
Has numerous intense metabolic effects (see Adverse Reactions and Side Effects). Suppresses adrenal function at chronic doses of 5 mg/day. See prednisone for numerous additional nursing implications. Adverse Effects (1%). CNS: Euphoria, headache, insomnia, confusion, psychosis. CV: CHF, edema. Check and record. See prednisone for numerous additional nursing implications. Adverse Effects (1%). CNS: Euphoria, headache, insomnia, confusion, psychosis. CV: CHF, edema. To decrease gastrointestinal irritation, instruct the patient to take prednisone with food. Assess muscle strength periodically to determine degree of muscle wasting during long- term use. Share This Book Share on Twitter.If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Please consult the latest official manual style if you have any questions regarding the format accuracy. Therapeutic: anti-inflammatories steroidal intermediate acting , immune modifiers.
Used systemically and locally in a wide variety of chronic diseases, including Inflammatory, Allergic, Hematologic, Neoplastic, Autoimmune disorders. Suitable for alternate-day dosing in the management of chronic illness. Unlabeled Use: Adjunctive therapy of hypercalcemia. Adjunctive management of nausea and vomiting from chemotherapy. In pharmacologic doses, suppresses inflammation and the normal immune response.
Has numerous intense metabolic effects see Adverse Reactions and Side Effects. Replaces endogenous cortisol in deficiency states. Has minimal mineralocorticoid activity. Therapeutic Effects: Suppression of inflammation and modification of the normal immune response. CNS: depression , euphoria , headache, increased intracranial pressure children only , personality changes, psychoses, restlessness.
EENT: cataracts, increased intraocular pressure. CV: hypertension. Derm: acne , decreased wound healing , ecchymoses , fragility , hirsutism , petechiae.
Endo: adrenal suppression , hyperglycemia. F and E: fluid retention long-term high doses , hypokalemia, hypokalemic alkalosis. Metab: weight gain, weight loss. MS: muscle wasting , osteoporosis , aseptic necrosis of joints, muscle pain. Misc: cushingoid appearance moon face, buffalo hump , increased susceptibility to infection. Monitor signs of thrombophlebitis lower extremity swelling, warmth, erythema, tenderness and thromboembolism shortness of breath, chest pain, cough, bloody sputum.
Notify physician immediately, and request objective tests Doppler ultrasound, lung scan, others if thrombosis is suspected. Monitor and report signs of peptic ulcer, including heartburn, nausea, vomiting blood, tarry stools, and loss of appetite. Assess signs of increased intracranial pressure in children, including changes in mood and behavior, decreased consciousness, headache, lethargy, seizures, and vomiting.
Notify physician immediately of these signs. Assess any muscle or joint pain. Report persistent or increased musculoskeletal pain to determine presence of bone or joint pathology aseptic necrosis, fracture. Assess muscle strength periodically to determine degree of muscle wasting during long- term use. Measure blood pressure periodically and compare to normal values See Appendix F.
Report a sustained increase in blood pressure hypertension to the physician. Assess peripheral edema using girth measurements, volume displacement, and measurement of pitting edema See Appendix N.
Report increased swelling in feet and ankles or a sudden increase in body weight due to fluid retention. Monitor personality changes, including depression, euphoria, restlessness, hallucinations, and psychosis. Notify physician if these changes become problematic. Be alert for signs of low potassium levels hypokalemia and metabolic acidosis, including hyperventilation, cardiac arrhythmias, dizziness, and confusion.
Notify physician immediately if these signs occur. Report signs of adrenal suppression, Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. This div only appears when the trigger link is hovered over.
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