CASE STUDY 2 – ENDOCRINE Instructions: Read the case study.

CASE STUDY 2 – ENDOCRINE Instructions: Read the case study. Answer… CASE STUDY 2 – ENDOCRINEInstructions: Read the case study. Answer s 1 – 12. Use the Rosdahl, Timby and drug books (notGoogle). For eachanswered, cite the page number(s) of your reference(s). All s apply to thiscase study. Your response should be brief and to the point. When asked to provide several answers, theyshould be listed in order of priority or significance. Do not assume information that is not provided.E. H. is a 60-year old woman who has rheumatoid arthritis. For the past 12 years she has been takingprednisone 60 mg daily (40 mg in the AM, 20 mg in the PM), and nonsteroidal anti-inflammatory drugs(NSAIDs) to control her disease and symptoms. As a result of her autoimmune disorder and/or long-termsteroid use, E. H. has adrenal insufficiency. The physician adjusts her steroid dosage for replacement therapy.In your nursing role, you are asked to conduct educational sessions designed to teach E. H. about hercondition and the treatment she needs. 1. E. H. states she doesn’t understand how her taking steroids has caused her body to lose it’s ability toproduce the “the real thing.” How would you explain this paradox in terms she can understand?2.People receiving steroid replacement should be taught sign/symptoms that signal the dosage is toolow. What are the signs/symptoms of inadequate steroid replacement?3.What would you teach someone like E. H. about the nutritional implications of adrenal insufficiency?AExplain why the AM dosage of prednisone is higher.5E. H. confides in you that she is afraid of taking steroids any longer because she has read about thedeleterious effects of steroid abuse by athletes. How would you counter this misconception andalleviate E. H.’s concern?6.How would teaching differ for this patient (on replacement therapy) as compared with teachingrequired for the patient taking therapeutic doses of glucocorticoids?7.The patient states she is under a lot of stress because of her son’s recent diagnosis of cancer and herhusband’s upcoming retirement. What are the teaching implications of this information?8.You realize that taking exogenous cortisol can result in a variety of pathophysiologic alterations oftendescribed as Cushing’s syndrome. Since E. H. will be taking lifelong steroids, would you expect to seethe signs/symptoms associated with Cushing’s syndrome in this individual? Explain your answer.9.What signs/symptoms should you teach E. H. to monitor that would indicate excessive drug therapy?10. You instruct E. H. on administration of a parenteral form of hydrocortisone. Under whatcircumstances should she take the parenteral form of the drug?11. What measures should E. H. take to prevent an acute episode of adrenal insufficiency?12. E. H. tells you she never used to take pills at all. She says she hates to be “addicted to a drug.” What”will you tell her?Health Science Science Nursing

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