What are two major risks of long-term systemic corticosteroids and one nursing action to mitigate?

• A. Hypertension and edema; monitor blood pressure regularly.
• B. Immunosuppression and infection risk; monitor signs of infection, glucose levels, and taper slowly to discontinue.
• C. Weight gain and insomnia; encourage sleep hygiene.
• D. Chronic kidney injury and electrolyte imbalance; monitor creatinine and electrolytes.

Answer: (B)

Prolonged systemic corticosteroids blunt the immune system, making infections much more likely and potentially more severe. That immunosuppressive effect is the major risk clinicians worry about because infections can escalate quickly in these patients. A key nursing action to mitigate this is to monitor for signs of infection (fever, chills, cough, wound healing issues, new or worsening symptoms) and to check blood glucose because steroids commonly cause hyperglycemia. Additionally, tapering the dose slowly when discontinuing helps the body's own cortisol production recover, preventing adrenal insufficiency and withdrawal symptoms. While other effects like hypertension, edema, weight gain, insomnia, or electrolyte changes can occur, the combination of immunosuppression and infection risk is most clinically significant, and the recommended nursing actions directly address those risks.