A nurse is caring for a patient with rheumatoid arthritis who is experiencing a flare-up. The patient has received corticosteroid injections in the past but is concerned about potential side effects. Which of the following side effects should the nurse inform the patient to monitor for when using glucocorticoids?

Rationale: A. Glucocorticoids do not improve muscle strength. In fact, long-term corticosteroid use can cause steroid-induced myopathy, which leads to muscle weakness, particularly in the proximal muscles of the thighs and shoulders. This side effect can reduce the patient’s overall physical function and mobility rather than enhancing it. Therefore, this is not an expected or beneficial effect of corticosteroid therapy. B. Glucocorticoids are immunosuppressive, meaning they reduce the body’s ability to mount an immune response. This places the patient at increased risk of infections, including opportunistic infections. Patients should be educated to monitor for signs of infection such as fever, cough, sore throat, or unusual fatigue, and seek medical attention promptly if symptoms occur. C. Corticosteroids affect carbohydrate, protein, and fat metabolism, which can lead to elevated blood glucose levels, particularly in patients with pre-existing diabetes or impaired glucose tolerance. They also cause fluid retention and increased vascular sensitivity to catecholamines, which can elevate blood pressure. Patients should monitor for symptoms such as increased thirst, frequent urination, fatigue, headaches, or swelling, and regularly check their blood pressure and glucose levels as recommended by their healthcare provider. This monitoring is essential to detect and manage complications early. D. While glucocorticoids can reduce inflammation and alleviate pain during a flare-up, they do not directly improve joint mobility. Improvements in mobility are usually achieved through physical therapy, exercise, and long-term disease-modifying antirheumatic drugs (DMARDs) rather than corticosteroid therapy alone