A nurse is teaching a patient with systemic lupus erythematosus (SLE) about prednisone. What information is a priority?

Choice A reason: Abrupt discontinuation of prednisone can lead to adrenal insufficiency, a potentially life-threatening condition. Prednisone suppresses the hypothalamic-pituitary-adrenal (HPA) axis, and sudden withdrawal can prevent the body from producing adequate cortisol. Tapering the dose gradually allows the adrenal glands to resume normal function. Choice B reason: Fat redistribution, such as moon face, buffalo hump, and central obesity, is a known long-term side effect of corticosteroids. However, while important, it is not the most immediate or life-threatening concern compared to adrenal crisis. Choice C reason: Feeling jittery or nervous may occur due to prednisone’s stimulant-like effects on the central nervous system, but this is a minor side effect and not a priority teaching point. Choice D reason: Sodium and fluid retention can lead to hypertension and edema, especially with long-term use. While relevant, these effects are not as critical as the risk of adrenal suppression from abrupt cessation.