When caring for a school-age child undergoing long-term hydrocortisone therapy, what is the primary assessment the nurse should prioritize?

When a child is undergoing long-term hydrocortisone therapy, one of the significant concerns is the impact of corticosteroids on growth and development. Hydrocortisone, as an adrenocortical agent, can affect various metabolic processes and suppress growth hormone levels, leading to potential growth delays or developmental issues in children.

Regular evaluation of growth and development is essential because this therapy can interfere with the child’s natural growth patterns. The health care provider needs to assess height, weight, and developmental milestones to identify any deviations from expected growth trajectories. Early detection of any growth impairment allows for timely intervention, which could include adjusting the dosage of hydrocortisone or exploring additional treatments to support growth.

While monitoring vital signs, assessing respiratory function, and examining skin integrity are important components of care, they do not specifically address the unique risk factors associated with long-term corticosteroid therapy in children as thoroughly as evaluating growth and development does. This focus on growth ensures a comprehensive approach to the child's health and well-being throughout the course of treatment.