What should the nurse inform a steroid-dependent client undergoing surgery about their medication dosage?

When a client who is dependent on steroids is undergoing surgery, it is crucial to increase their medication dosage. This is primarily due to the significant stress that surgery places on the body, which can lead to an increased demand for corticosteroids. Steroid-dependent patients may have an impaired ability to produce their own cortisol in response to stress. In the context of surgery, the risk of adrenal insufficiency becomes heightened; therefore, it’s essential to provide adequate doses of corticosteroids to mimic the physiological response to stress.

Increasing the dosage helps to prevent complications related to inadequate steroid levels, such as adrenal crisis, which can be life-threatening. Surgeons and anesthesiologists often use stress dosing protocols for individuals on long-term corticosteroid therapy to ensure that their body is supported properly during and after the surgical procedure. This management strategy is particularly important for those with conditions like Addison's disease or those who have been on long-term glucocorticoid therapy, where the adrenal glands may have atrophied and are less capable of responding to the body's increased needs during stress.