The discharge teaching for a client with Cushing's disease includes which statement demonstrating understanding?

• A. I will notify my health-care provider if I start to run a fever.
• B. Before I stop taking prednisone, I will be taught how to taper it off.
• C. If I get weak and shaky, I need to eat some hard candy or drink some juice.
• D. It is fine if I continue to participate in weekend games of tackle football.

Answer: (B)

Safely stopping long-term steroid therapy requires tapering to allow the adrenal glands to recover and to prevent adrenal insufficiency. When prednisone has been used for a prolonged period, the hypothalamic-pituitary-adrenal axis suppresses its own cortisol production. Stopping suddenly removes the external source of cortisol, and the body may not respond adequately, leading to fatigue, weakness, hypotension, nausea, and other withdrawal symptoms or a crisis. Tapering gradually gives the body time to resume its own cortisol production and reduces withdrawal risk.

Other options don’t demonstrate understanding of this issue as clearly: fever should be reported because steroids can mask infections, but it doesn’t address how to stop the medication safely; continuing intense activity like tackle football ignores the increased infection risk and potential bone health concerns; and treating weakness with candy or juice touches on hypoglycemia management in other conditions, not the steroid withdrawal process.