A nurse is screening clients for adrenal insufficiency. The nurse recognizes that which client is at greatest risk for adrenal insufficiency?
A 19-year-old male on low dose steroids for a week
A 35-year-old female who completed 3 weeks of steroids.
An 80-year-old female who takes steroids daily.
A 45-year old male with COPD who uses intermittent steroids.
The Correct Answer is C
A. A short-term, low-dose steroid use (one week) has minimal risk for adrenal suppression.
B. Three weeks of steroids increases risk, but daily use presents a higher risk.
C. Prolonged daily steroid use, especially in an older adult, poses the greatest risk for adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
D. Intermittent steroid use is less likely to cause adrenal insufficiency compared to daily long-term use.
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Correct Answer is B
Explanation
A. While hormones from the adrenal cortex do influence various metabolic processes, mineralocorticoids primarily focus on fluid and electrolyte balance rather than having major effects on all organs' metabolism.
B. Mineralocorticoids, such as aldosterone, play a crucial role in regulating fluid and electrolyte balance by promoting sodium retention and potassium excretion in the kidneys.
C. Regulation of carbohydrate and protein metabolism is mainly the function of glucocorticoids, not mineralocorticoids.
D. The release of ACTH is regulated by corticotropin-releasing hormone (CRH) from the hypothalamus, not directly influenced by mineralocorticoids.
Correct Answer is A
Explanation
A. The primary purpose of administering an osmotic diuretic, such as mannitol, is to lower ICP by promoting diuresis, which results in increased urinary output and decreases fluid volume in the brain.
B. Osmotic diuretics do not specifically reduce cerebral blood flow; rather, they work by reducing fluid volume and thus intracranial pressure.
C. While osmotic diuretics can help manage edema, their primary role is not solely to prevent the formation of cerebral edema but to actively reduce existing pressure.
D. Osmotic diuretics do not directly decrease brain oxygen consumption; their main function is to create an osmotic gradient that pulls fluid from the brain to reduce ICP.