Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison's disease?

Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison's disease?

• A. Discuss the importance of tapering medications when discontinuing medication.
• B. Explain the dose may need to be increased during times of stress or infection.
• C. Instruct the client to take medication on an empty stomach with a glass of water.
• D. Encourage the client to wear clean white socks when wearing tennis shoes.

Answer: (B)

The key idea is that glucocorticoid replacement for Addison’s disease must be adjusted during times of physical stress because the body’s need for cortisol rises. If the dose isn’t increased during illness, fever, infection, or stress (and sometimes surgery), the patient can develop an adrenal crisis with life-threatening hypotension and shock. Therefore, teaching the patient to recognize when stress is present and to increase the glucocorticoid dose as advised by the clinician is essential for safety and stability. Explain that during illness or infection, the typical daily replacement isn’t enough and a higher dose is often required. The patient should know to contact their healthcare provider for specific dosing guidance during these times and to seek urgent care if symptoms suggest adrenal crisis (for example, severe weakness, confusion, vomiting, or high fever). This instruction directly supports maintaining adequate cortisol activity when the body’s demand is elevated. Other instructions aren’t as aligned with this critical need. Tapering off medications is relevant only if discontinuing therapy, which isn’t the scenario for someone ongoing with Addison’s replacement. Taking medication on an empty stomach isn’t a standard requirement and can cause GI irritation; these steroids are usually taken with meals. The suggestion about wearing white socks with tennis shoes isn’t related to adrenal management.

The key idea is that glucocorticoid replacement for Addison’s disease must be adjusted during times of physical stress because the body’s need for cortisol rises. If the dose isn’t increased during illness, fever, infection, or stress (and sometimes surgery), the patient can develop an adrenal crisis with life-threatening hypotension and shock. Therefore, teaching the patient to recognize when stress is present and to increase the glucocorticoid dose as advised by the clinician is essential for safety and stability.

Explain that during illness or infection, the typical daily replacement isn’t enough and a higher dose is often required. The patient should know to contact their healthcare provider for specific dosing guidance during these times and to seek urgent care if symptoms suggest adrenal crisis (for example, severe weakness, confusion, vomiting, or high fever). This instruction directly supports maintaining adequate cortisol activity when the body’s demand is elevated.

Other instructions aren’t as aligned with this critical need. Tapering off medications is relevant only if discontinuing therapy, which isn’t the scenario for someone ongoing with Addison’s replacement. Taking medication on an empty stomach isn’t a standard requirement and can cause GI irritation; these steroids are usually taken with meals. The suggestion about wearing white socks with tennis shoes isn’t related to adrenal management.