A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?

This assessment focuses on the systemic side effects of chronic corticosteroid therapy in a child. Knowledge of endocrine physiology and the impact of glucocorticoids on mineral metabolism and bone remodeling is necessary to monitor for potential long-term skeletal complications. Choice A rationale Glucocorticoids like prednisolone are known to increase intraocular pressure rather than decrease it. Long-term use can lead to steroid-induced glaucoma or cataracts by interfering with the drainage of aqueous humor within the eye structures. Choice B rationale Prednisolone stimulates gluconeogenesis and decreases peripheral glucose utilization. This metabolic shift leads to hyperglycemia, not hypoglycemia. Children on long-term steroids require monitoring for elevated blood sugar levels and potential steroid-induced diabetes mellitus. Choice C rationale Steroids cause sodium and water retention alongside increased appetite, typically resulting in weight gain and a cushingoid appearance. Weight loss is unintended and inconsistent with the fluid retention and metabolic changes associated with prednisolone. Choice D rationale Prednisolone inhibits osteoblast activity and reduces calcium absorption in the gastrointestinal tract. This leads to a reduction in bone mineral density, putting the school-age child at an increased risk for fractures and growth retardation.