When monitoring a patient who is taking intravenous dexamethasone, the nurse will monitor for signs of which condition?

Choice A reason: Moon face, a hallmark of long-term prednisone use, results from fat redistribution due to corticosteroid-induced metabolic changes. Prednisone promotes lipogenesis in facial and neck areas, causing a rounded, puffy appearance. This Cushingoid feature is a common, visible side effect of prolonged systemic corticosteroid therapy.

Choice B reason: Weight loss is not typical with long-term prednisone therapy. Prednisone increases appetite and promotes fat deposition, leading to weight gain, not loss. Catabolic effects on muscle may occur, but overall weight gain, including fluid retention, is more characteristic, making this incorrect.

Choice C reason: Pale skin color is not a common effect of prednisone. Corticosteroids can cause skin thinning or bruising due to reduced collagen synthesis, but pallor is not typical. Hyperpigmentation may occur in some cases, but moon face is the primary appearance-related side effect of long-term use.

Choice D reason: Hair loss is not a primary side effect of prednisone. Corticosteroids may cause hirsutism or thinning skin, but hair loss is more associated with chemotherapy or other drugs. Prednisone’s metabolic effects lead to fat redistribution, like moon face, rather than alopecia, making this incorrect.

Choice A reason: Prednisone is not contraindicated in cerebral edema; it is often used to reduce swelling by decreasing inflammation and vascular permeability. Its anti-inflammatory effects stabilize the blood-brain barrier, making it beneficial in conditions like cerebral edema caused by trauma or tumors, though monitoring is required.

Choice B reason: Prednisone is contraindicated in peptic ulcer disease due to its ability to increase gastric acid secretion and reduce mucosal protection, exacerbating ulcers or causing gastrointestinal bleeding. Corticosteroids inhibit prostaglandin synthesis, weakening the gastric lining, which can lead to severe complications in patients with pre-existing ulcers.

Choice C reason: Prednisone is not contraindicated in chronic obstructive pulmonary disease (COPD). It is used in acute exacerbations to reduce airway inflammation and improve symptoms. While long-term use requires caution due to systemic side effects, it is not contraindicated and is often part of COPD management protocols.

Choice D reason: Tuberculous meningitis is not an absolute contraindication for prednisone. In fact, corticosteroids like prednisone are used adjunctively with antitubercular therapy to reduce inflammation and prevent complications like hydrocephalus. Careful monitoring is needed to avoid worsening infection, but it is not contraindicated in this condition.