Adverse effects of corticosteroids and immunosuppressants
Adverse effects of corticosteroids and immunosuppressants ( 5 Questions)
A nurse is administering fludrocortisone (Florinef), a mineralocorticoid, to a client who has Addison's disease. What are some of the contraindications for this drug? (Select all that apply)
Known hypersensitivity to fludrocortisone or any component of the drug . Hypersensitivity is an exaggerated or inappropriate immune reaction to a substance that can cause allergic reactions such as rash, itching, hives, swelling, or difficulty breathing. The nurse should instruct the client to stop taking fludrocortisone and seek immediate medical attention if they experience any of these symptoms.
Pregnancy . Pregnancy is a condition in which a woman carries a developing fetus in her uterus. Fludrocortisone is a mineralocorticoid that can cross the placenta and affect the fetus. Fludrocortisone can cause fetal growth retardation, low birth weight, cleft palate, and adrenal insufficiency in the newborn. The nurse should instruct the client to use effective contraception while taking fludrocortisone and to inform their doctor if they become pregnant or plan to become pregnant.
Lactation . Lactation is the production and secretion of breast milk by a woman who has given birth. Fludrocortisone is a mineralocorticoid that can pass into breast milk and affect the nursing infant. Fludrocortisone can cause electrolyte imbalance, growth suppression, and adrenal suppression in the infant. The nurse should instruct the client not to breastfeed while taking fludrocortisone and to consult their doctor about alternative feeding methods.
Diabetes mellitus, hypertension, heart failure, osteoporosis, glaucoma, cataracts, renal or hepatic impairment, bleeding disorders, and concurrent use of other immunosuppressive agents or live vaccines are not contraindications for fludrocortisone, but they are cautions or risk factors that may increase the likelihood of adverse effects or require dose adjustment or monitoring . These are conditions or factors that may affect the metabolism, excretion, efficacy, or safety of fludrocortisone. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests, and immune status during treatment. The nurse should also educate the client about the potential adverse effects of fludrocortisone and how to prevent or manage them.
Hypertension, heart failure, renal or hepatic impairment, and concurrent use of other immunosuppressive agents or live vaccines are not specific contraindications for fludrocortisone, but they are cautions or risk factors that may increase the likelihood of adverse effects or require dose adjustment or monitoring . These are conditions or factors that may affect the metabolism, excretion, efficacy, or safety of fludrocortisone. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests, and immune status during treatment. The nurse should also educate the client about the potential adverse effects of fludrocortisone and how to prevent or manage them.
Active infection, malignancy, pregnancy, lactation, peptic ulcer disease, and bleeding disorders are not specific contraindications for fludrocortisone, but they are contraindications for glucocorticoids in general . Glucocorticoids are a class of drugs that include fludrocortisone and prednisone. They have anti-inflammatory, immunosuppressive, and metabolic effects by binding to glucocorticoid receptors and modulating gene expression. Glucocorticoids can cause serious side effects such as infection, malignancy, teratogenicity, gastrointestinal bleeding and ulceration, and bleeding disorders by suppressing the immune system, increasing the risk of opportunistic infections and cancers, crossing the placenta and breast milk, inhibiting gastric mucosal protection and healing, and reducing platelet aggregation and clotting factors . The nurse should use glucocorticoids with caution in patients with these conditions or risk factors and monitor them closely for signs and symptoms of complications.
Known hypersensitivity to fludrocortisone or any component of the drug . Hypersensitivity is an exaggerated or inappropriate immune reaction to a substance that can cause allergic reactions such as rash, itching, hives, swelling, or difficulty breathing. The nurse should instruct the client to stop taking fludrocortisone and seek immediate medical attention if they experience any of these symptoms.
Pregnancy . Pregnancy is a condition in which a woman carries a developing fetus in her uterus. Fludrocortisone is a mineralocorticoid that can cross the placenta and affect the fetus. Fludrocortisone can cause fetal growth retardation, low birth weight, cleft palate, and adrenal insufficiency in the newborn. The nurse should instruct the client to use effective contraception while taking fludrocortisone and to inform their doctor if they become pregnant or plan to become pregnant.
Lactation . Lactation is the production and secretion of breast milk by a woman who has given birth. Fludrocortisone is a mineralocorticoid that can pass into breast milk and affect the nursing infant. Fludrocortisone can cause electrolyte imbalance, growth suppression, and adrenal suppression in the infant. The nurse should instruct the client not to breastfeed while taking fludrocortisone and to consult their doctor about alternative feeding methods.
The other options are incorrect because:
B. Diabetes mellitus, hypertension, heart failure, osteoporosis, glaucoma, cataracts, renal or hepatic impairment, bleeding disorders, and concurrent use of other immunosuppressive agents or live vaccines are not contraindications for fludrocortisone, but they are cautions or risk factors that may increase the likelihood of adverse effects or require dose adjustment or monitoring . These are conditions or factors that may affect the metabolism, excretion, efficacy, or safety of fludrocortisone. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests, and immune status during treatment. The nurse should also educate the client about the potential adverse effects of fludrocortisone and how to prevent or manage them.
C. Hypertension, heart failure, renal or hepatic impairment, and concurrent use of other immunosuppressive agents or live vaccines are not specific contraindications for fludrocortisone, but they are cautions or risk factors that may increase the likelihood of adverse effects or require dose adjustment or monitoring . These are conditions or factors that may affect the metabolism, excretion, efficacy, or safety of fludrocortisone. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests. The nurse should assess the client's medical history and current medications before administering fludrocortisone and monitor their vital signs, blood glucose, electrolytes, bone density, intraocular pressure, liver function tests, coagulation tests, and immune status during treatment. The nurse should also educate the client about the potential adverse effects of fludrocortisone and how to prevent or manage them.
D. Active infection, malignancy, pregnancy, lactation, peptic ulcer disease, and bleeding disorders are not specific contraindications for fludrocortisone, but they are contraindications for glucocorticoids in general . Glucocorticoids are a class of drugs that include fludrocortisone and prednisone. They have anti-inflammatory, immunosuppressive, and metabolic effects by binding to glucocorticoid receptors and modulating gene expression. Glucocorticoids can cause serious side effects such as infection, malignancy, teratogenicity, gastrointestinal bleeding and ulceration, and bleeding disorders by suppressing the immune system, increasing the risk of opportunistic infections and cancers, crossing the placenta and breast milk, inhibiting gastric mucosal protection and healing, and reducing platelet aggregation and clotting factors . The nurse should use glucocorticoids with caution in patients with these conditions or risk factors and monitor them closely for signs and symptoms of complications.