مريض يأخذ بريدنيزولون ٢٠ ملغ يومياً منذ ٦ أشهر، وسيدخل عملية كبيرة وهو صائم. ماذا تتوقع الممرضة؟

A client has taken prednisolone 20 mg daily for 6 months and is NPO for major surgery. What does the nurse expect?

1. IV hydrocortisone given around the time of surgery
2. Doubling the oral prednisolone dose on the morning of surgery
3. Switching to an inhaled steroid until the surgery is over
4. Stopping the steroid until he eats again after surgery

Answer: A) IV hydrocortisone given around the time of surgery. Long-term steroids suppress the adrenal glands, which then cannot raise cortisol under surgical stress; stopping or not covering them risks adrenal crisis with hypotension and shock. A stress dose is given IV, not orally, because he is NPO.