ACCNS-AG Adult-Gerontology Acute Care Clinical Nurse Specialist Certification

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A patient on chronic prednisone 20 mg daily for rheumatoid arthritis requires emergency appendectomy. What is the critical perioperative pharmacological concern?

Risk of postoperative bleeding due to prednisone's antiplatelet effects Hypothalamic-pituitary-adrenal (HPA) axis suppression requiring stress-dose steroids Increased risk of prednisone toxicity due to surgical anesthesia interactions Need to discontinue prednisone 48 hours preoperatively to prevent wound dehiscence

Correct Answer:

Hypothalamic-pituitary-adrenal (HPA) axis suppression requiring stress-dose steroids

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