A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

A. The immediate concern with abrupt cessation is more related to adrenal insufficiency rather than hyperglycemia. However, chronic use of prednisone can contribute to glucose intolerance and diabetes, but this is not the primary issue with sudden discontinuation.
B. Abrupt discontinuation of prednisone can lead to adrenal insufficiency because the body has become reliant on the medication to suppress inflammation and regulate various bodily functions. The adrenal glands may not immediately resume normal cortisol production, which can lead to symptoms of adrenal insufficiency, including hypotension.

C. Fluid retention is a common side effect of prednisone use. However, stopping prednisone suddenly does not typically cause fluid retention; rather, it can lead to other issues like adrenal insufficiency. Fluid retention is more related to the medication's use rather than its abrupt discontinuation.
D. Abruptly stopping high-dose prednisone, especially after long-term use, can be dangerous. The body may not immediately resume normal cortisol production, leading to symptoms of adrenal insufficiency, such as fatigue, weakness, and hypotension. It is crucial to taper off prednisone gradually under medical supervision to allow the adrenal glands time to recover and to avoid withdrawal symptoms.

A. Age-related hearing loss, also known as presbycusis, is a common condition among older adults. It typically involves a gradual decline in hearing ability due to changes in the inner ear or auditory nerve as people age. This statement acknowledges a common experience and helps normalize the patient's condition without suggesting immediate medical intervention or attributing it to something specific.
B. While hearing aids can significantly improve the quality of life for individuals with hearing loss, not all cases immediately require them. It’s important to assess the severity of hearing loss and discuss various options with the patient, including potential benefits and drawbacks of hearing aids.
C. Hearing loss that develops gradually over time is usually related to aging, not an infection. While infections can cause temporary hearing loss, age-related hearing loss is a different issue and is typically not due to an infection.
D. While some medications can cause temporary or permanent hearing loss as a side effect (a condition known as ototoxicity), it’s important to consult a healthcare provider before making any changes to medication regimens.