مريض يأخذ بريدنيزولون ١٥ ملغ يومياً منذ سنة لالتهاب المفاصل، ومجدول لعملية كبيرة في البطن غداً. ما التوقع بخصوص الكورتيزون؟

A client has taken prednisolone 15 mg daily for a year for arthritis and is scheduled for major abdominal surgery tomorrow. What is expected regarding steroids?

1. Extra hydrocortisone peri-operatively per protocol
2. Stop the steroid three days before surgery
3. Halve the dose on the day of surgery
4. Give no steroid until he eats by mouth

Answer: A) Extra hydrocortisone peri-operatively per protocol. Long-term use suppresses the adrenal glands, which cannot respond to surgical stress, so stress-dose steroids are given to prevent adrenal crisis.