In: Nursing
CRITICAL THINKING EXERCISES
A 75-year-old patient has a new prescription for corticosteroid therapy. Describe the assessment techniques appropriate to evaluate the patient and the use of the medication. What instructions should you provide regarding precautions to take related to corticosteroid therapy? How will your assessment and instructions differ if the patient is disoriented?
A) Describe the assessment techniques appropriate for to evaluate the patient and the use of the medication:-
* Monitor daily weight - corticosteroids can cause weight gain.
* Assess for blurring of vision or decreased vision.
* Monitor Blood Pressure regularly- may cause hypertension.
* Monitor blood glucose level - may increase blood glucose level
* Monitor serum electrolytes- decrease serum calcium and causes osteoporosis, and hypokalemia (decreased potassium)
* Assess for signs of any infections and poor wound healing - increased risk of infection ,because corticosteroids suppress immune response.
* Assess for regular use and no abruptly stoping the medication.
B) Instructions regarding precautions:-
* Take medication as prescribed.
* Do not stop abruptly and with out doctor's advice.
* Monitor blood glucose and serum electrolytes periodically .
* Can produce insomnia.
* Can cause osteoporosis and pathological fracture.
* Medication cause weight gain and facial puffiness, increase the physical exercises and check weight .
* Take low- calorie and low- sodium and low- fat diet to control weight gain and swelling.
* Advice to keep away from infections and if any signs of infections report and get medical care immediately.
C) How will your assessment and instructions differ if the patient is disoriented:-
* Frequent eye examinations by ophthalmologist.
* Instruct the care taker regarding regular assessment of weight,serum electrolytes,BP, and medication administration.
* Assess for osteoporosis and for any pathological fractures.
* Do not allow the patient to move alone,always assist the patient.