What should a nurse assess for when a patient is receiving long-term glucocorticoid therapy?

Monitoring for signs of adrenal suppression is crucial when a patient is undergoing long-term glucocorticoid therapy because these medications can inhibit the body’s natural production of cortisol. The pituitary gland responds to elevated glucocorticoid levels by reducing secretion of adrenocorticotropic hormone (ACTH), which ultimately leads to reduced adrenal gland activity.

Symptoms of adrenal suppression may include fatigue, weakness, hypotension, and an inability to respond effectively to stress, which can be critical in times of illness or injury. Regular assessment for these signs allows for timely interventions if the patient's adrenal function becomes compromised, thus preventing complications such as adrenal crisis.

In contrast, increased muscle mass, improvement in glucose tolerance, and an enhanced immune response are typically not outcomes associated with prolonged glucocorticoid therapy. In fact, these agents often lead to muscle wasting, impaired glucose tolerance, and an increased risk of infections due to their immunosuppressive effects. Thus, focusing on adrenal suppression is essential to ensure patient safety and well-being during long-term treatment.