Practice Quiz

CMSRN Medical-Surgical Nursing

Category - Endocrine

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Joshua Caine, age 48 years old, had a bilateral adrenalectomy for Cushing’s syndrome. He is being sent home with a new prescription for hydrocortisone. The best statement indicating understanding of the drug and associated risk is:
  1. “I am taking this drug to replace the hormones usually secreted by the adrenal medulla.”
  2. “I should take this pill every morning before breakfast.”
  3. “This pill may cause weight gain so I should exercise and eat less.”
  4. “I should call the doctor if I think I am starting a cold and I should not take aspirin.”
Explanation
Answer - D - “I should call the doctor if I think I am starting a cold and I should not take aspirin.” Usually the cortex of the adrenal gland (not the medulla) increases secretion of cortisol to stimulate the immune system in response to an infection. Thus the replacement dose during the illness may need to be adjusted once a client’s adrenal glands are removed. Hydrocortisone can irritate the gastric mucosa and so clients should take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
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