Page 1449 - Saunders Comprehensive Review For NCLEX-RN

10. Instruct the client that it is best to take medication in
the early morning with food or milk.
11. Advise the client to eat foods high in potassium.
12. Instruct the client to avoid individuals with infections.
13. Advise the client to inform all PHCPs of the
medication regimen.
14. Instruct the client to report signs and symptoms of
Cushing’s syndrome, including a moon face, puffy
eyelids, edema in the feet, increased bruising,
dizziness, bleeding, and menstrual irregularities,
which often results from the large doses of long-term
glucocorticoids that may be used to treat
nonendocrine conditions.
15. Note that the client may need additional doses during
periods of stress, such as surgery.
16. Instruct the client not to stop the medication abruptly,
because abrupt withdrawal can result in severe
adrenal insufficiency.
17. Advise the client to consult with the PHCP before
receiving vaccinations; live virus vaccines should not
be administered to the client taking glucocorticoids.
18. Advise the client to wear a MedicAlert bracelet.
VIII. Androgens (Box 47-6)

A. Description

1. Used to replace deficient hormones or to treat
hormone-sensitive disorders
2. Can cause bleeding if the client is taking oral
anticoagulants (increase the effect of anticoagulants)
3. Can cause decreased serum glucose concentration,
thereby reducing insulin requirements in the client
with diabetes mellitus
4. Hepatotoxic medications are avoided with the use of
androgens because of the risk of additive damage to
the liver.
5. Androgens usually are avoided in men with known
prostate or breast carcinoma, because androgens often
stimulate growth of these tumors.
B. Side and adverse effects
1. Masculine secondary sexual characteristics (body hair
growth, lowered voice, muscle growth)
2. Bladder irritation and urinary tract infections
3. Breast tenderness
4. Gynecomastia
5. Priapism
6. Menstrual irregularities
7. Virilism
8. Sodium and water retention with edema

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