What should the nurse most importantly assess in a child receiving long-term therapy with systemic corticosteroids?

In a child receiving long-term systemic corticosteroid therapy, the most critical assessment for the nurse is the growth pattern. Corticosteroids can significantly impact growth and development, as they may inhibit the secretion of growth hormone and interfere with normal growth processes. Monitoring growth patterns allows the healthcare provider to identify any potential growth delays or abnormalities early on, which is essential for adjusting treatment protocols or considering alternative therapies.

Regularly assessing a child's growth pattern through measurements of height and weight, plotted on growth charts, provides valuable data regarding their development in comparison to expected growth standards for their age and sex. This assessment can guide interventions that may be necessary to mitigate any negative effects of corticosteroid treatment on growth.

While hydration levels, skin integrity, and weight fluctuations are also important in the overall care of a child on corticosteroids, they do not directly relate to the critical impact that these medications have on growth. Therefore, growth pattern assessment takes precedence in this context.