Question

Client teaching regarding long-term corticosterodd therapy should include: a. the need for periodic blood glucose assessment \(\mathrm{b}\). the need to take the medication late in the day to avoid insomia c. the possibility of enhanced wound healing d. the need for a diet low in iron

Short answer

a. the need for periodic blood glucose assessment

Step-by-step solution

- Identify the Correct Needs for Long-Term Corticosteroid Therapy

Read through each option carefully and determine which ones align with proper client teaching for long-term corticosteroid use. Consider what is known about corticosteroids' effects on the body.

- Analyze Option (a)

Option (a) discusses the need for periodic blood glucose assessment. Long-term corticosteroid use can lead to hyperglycemia, so periodic blood glucose monitoring is indeed necessary.

- Analyze Option (b)

Option (b) suggests taking the medication late in the day to avoid insomnia. Corticosteroids typically should be taken early in the day to align with the body’s natural cortisol rhythm and to prevent insomnia.

- Analyze Option (c)

Option (c) mentions the possibility of enhanced wound healing. Corticosteroids are known to impair, not enhance, wound healing due to their immunosuppressive effects.

- Analyze Option (d)

Option (d) advises a diet low in iron. There is no specific need for a low iron diet when on long-term corticosteroid therapy. This is not supported by clinical guidelines.

- Conclusion

After carefully analyzing all options, determine which one correctly addresses a necessity in client teaching for long-term corticosteroid therapy. Option (a) accurately represents an important aspect of monitoring.

Key concepts

Blood Glucose Monitoring

Long-term corticosteroid therapy can significantly affect blood glucose levels. Corticosteroids can increase blood glucose, leading to hyperglycemia. Hence, regular blood glucose monitoring is crucial to prevent complications like diabetes.
It's essential to monitor blood glucose:

• Before starting corticosteroid therapy
• At regular intervals during treatment
• When dosages are changed

Keeping a close eye on blood sugar levels helps in adjusting medication and diet as needed. This proactive approach ensures better health management.

Medication Timing

Taking corticosteroids at the right time of day is essential to minimize side effects. It's generally recommended to take them earlier in the day, aligning with the body's natural cortisol rhythm. This helps in reducing the risk of insomnia and other sleep disorders.
Here are some tips:

• Take the medication in the morning, ideally after breakfast.
• Maintain a consistent schedule to avoid missed doses.
• If instructed by your healthcare provider, split higher doses into smaller ones throughout the day.

Proper timing can significantly improve the effectiveness and reduce the negative impacts of corticosteroids.

Wound Healing

Corticosteroids have immunosuppressive effects, which can impair wound healing. They reduce inflammation but also decrease the body’s ability to repair tissues, making wounds slower to heal.
Follow these steps to promote better wound healing while on corticosteroids:

• Keep the wound clean and covered.
• Avoid unnecessary pressure or friction on the wound area.
• Follow a healthy diet rich in vitamins and minerals that promote healing, like Vitamin C and Zinc.
• Consult your healthcare provider for any signs of infection or slow-healing wounds.

Paying close attention to wound care can prevent complications and support better recovery.

Dietary Guidelines

A well-balanced diet is critical while on long-term corticosteroid therapy to counteract its side effects. Although a low iron diet isn't necessary, there are other important dietary considerations:

• Calcium and Vitamin D: Essential for preventing osteoporosis, which can be a side effect of corticosteroids.
• Potassium: Helps in combating corticosteroid-induced potassium depletion. Include foods like bananas and spinach.
• Low sodium: Reduces the risk of high blood pressure and fluid retention.

It's also a good idea to limit sugar intake to manage blood glucose levels effectively. Consulting with a registered dietitian can provide personalized dietary advice that supports overall well-being.