A nurse is planning to teach a client about taking prednisone.
Which of the following instructions should the nurse include
A.
Increase dietary calcium.
B.
Monitor for weight loss.
C.
Take on an empty stomach.
D.
Schedule dosage at bedtime.
The Correct Answer and Explanation is:
Correct Answer: A. Increase dietary calcium.
Explanation:
Prednisone is a corticosteroid commonly prescribed to manage various inflammatory and autoimmune conditions. While effective, long-term use of prednisone is associated with a variety of potential side effects that necessitate careful management and patient education. One critical side effect of long-term prednisone therapy is its impact on bone health, leading to an increased risk of osteoporosis and bone fractures.
Why Increase Dietary Calcium?
Corticosteroids like prednisone can reduce calcium absorption in the intestines, increase calcium excretion through the kidneys, and directly affect bone metabolism by inhibiting osteoblast (bone-forming cells) activity. These effects contribute to bone loss over time, increasing the risk of osteoporosis. To mitigate this risk, it is essential for clients on long-term prednisone therapy to increase their dietary intake of calcium and vitamin D, both of which are crucial for maintaining bone health. Foods rich in calcium include dairy products like milk, cheese, and yogurt, as well as green leafy vegetables, fortified cereals, and juices. Additionally, vitamin D supplements may be recommended to enhance calcium absorption.
Why Not the Other Options?
- B. Monitor for weight loss: Weight gain, not weight loss, is a more common side effect of prednisone. Prednisone can lead to an increase in appetite, fluid retention, and fat redistribution in the body, often resulting in weight gain.
- C. Take on an empty stomach: Prednisone should not be taken on an empty stomach. It is recommended to take it with food to reduce gastrointestinal irritation, which is a common side effect of this medication. Taking prednisone with food helps to minimize the risk of developing gastritis, ulcers, or stomach pain.
- D. Schedule dosage at bedtime: Prednisone should not be taken at bedtime. Corticosteroids can cause insomnia and restlessness if taken later in the day. The best time to take prednisone is in the morning, preferably before 9 a.m., to mimic the body’s natural circadian rhythm of cortisol production. This timing helps to reduce the risk of adrenal suppression and insomnia.
In conclusion, the primary teaching point for a client taking prednisone is to increase dietary calcium to protect against bone loss and osteoporosis. This proactive approach, combined with other lifestyle modifications like regular weight-bearing exercises and adequate vitamin D intake, can significantly reduce the risk of long-term complications associated with prednisone therapy.