Which adverse effects should a nurse discuss with a patient on long-term systemic corticosteroid therapy?

Patients undergoing long-term systemic corticosteroid therapy are at risk for a variety of adverse effects due to the potent nature of these medications and their impact on multiple body systems. The correct choice highlights a range of significant and common complications associated with such therapy.

Hyperglycemia can occur because corticosteroids can increase gluconeogenesis and impair insulin sensitivity, leading to elevated blood sugar levels. Peptic ulcers are a risk due to the tendency of corticosteroids to compromise the gastrointestinal mucosal barrier and increase gastric acid secretion, making the stomach lining more susceptible to damage. Mood disorders, such as anxiety or depression, are also common among patients using corticosteroids for long periods, as these medications can affect neurotransmitter levels in the brain. Finally, cataracts, especially posterior subcapsular cataracts, can develop due to long-term exposure to corticosteroids, which may cause changes in the eye's lens proteins and contribute to lens opacity.

In contrast, discussing only weight gain and insomnia limits the breadth of potential side effects that patients should be aware of. Similarly, focusing solely on gastrointestinal issues downplays other serious complications. Skin rashes and respiratory problems are not typically the most significant concerns related to long-term corticosteroid use in adults, making those options less comprehensive regarding the adverse