Dexamethasone is a glucocorticoid that suppresses inflammation and the immune response. It has numerous side effects involving many body systems if used long-term or improperly. It is indicated for chronic inflammatory disorders, allergies, hematologic diseases, neoplasms, and autoimmune diseases. Nursing care for dexamethasone involves frequent monitoring for side effects involving fluid balance, electrolytes, skin, respiratory status, and psychological changes. Patients require education about proper administration and reporting any adverse effects.

1. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY MECHANISMOF
ACTION
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICA-
TION
GLUCOCORTICOIDS
ANTI-
INFLAMMATORY
AGENT
-Suppresses
inflammation
and the
normal
immune
response. Has
numerous
intense
metabolic
effects
-Suppresses
adrenal
function at
chronic doses
of
0.75mg/day.
Practically
devoid of
mineralocortic
oid (sodium-
retaining)
activity
CNS: headache
dizziness,
spinning
sensation;
GI: nausea,
vomiting
INTEGU-
MENTARY:
acne, dry skin,
thinning skin,
bruising or
discoloration;
slow wound
healing;
increased
sweating;
MUSCULO-
SKELETAL:
muscle
weakness
EENT: problems with
vision; increased
intraocular pressure
METABOLISM:
swelling, rapid
weight gain, feeling
short of breath;
CNS: severe
depression, unusual
thoughts or behavior,
seizure (convulsions);
GI: bloody or tarry
stools, coughing up
blood; pancreatitis
(severe pain in upper
stomach spreading to
back, nausea and
vomiting, fast heart
rate);
-Used
systematically
and locally in
a variety of
disorders
including:
Chronic
Inflammatory
Disorders,
Allergies,
Hematologic
Diseases,
Neoplasm,
Autoimmune
Disease,
Management
of Cerebral
Edema and
Septic shock,
Diagnostic
agent in
adrenal
disorders
-This drug is
indicated for
many conditions.
Assess involved
systems prior to
and periodically
throughout the
course of therapy
-Monitor intake
and output ratios
and daily
weights. Observe
patient for
appearance of
peripheral
edema, steady
weight gain,
rales/crackles, or
dyspnea. Notify
physician if
these occur
-Children should
have periodic
evaluation of
growth
-Active untreated
infectious (exceprt
for certain forms
of meningitis)
-Avoid chronic use
during
lactation;may
affect child’s
growth
-Bisulfie, paraben
or alcohol
hypersensitivity—
some products
contain Bisulfie,
paraben or alcohol
-Use caustiously:
chronic treatment
(will lead to
adrenal
suppression);
should never be
abruptly
discontinue

2. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY MECHANISMOF
ACTION
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING CARE CONTRAINDI
CATION
-Suppression of
inflammation
and
modification of
normal immune
response
FLUID &
ELECTROLYTES:
Low potassium
(confusion, uneven
heart rate, extreme
thirst, increased
urination, leg
discomfort, muscle
weakness or limp
feeling);
CARDIO-
VASCU-
LAR: dangerously
high blood pressure
(severe headache,
blurred vision,
buzzing in ears,
anxiety, confusion,
chest pain,
shortness of breath,
uneven heartbeats,
seizure).
-Short-term
administration
to high-risk
mothers before
delivery to
prevent distress
syndrome in the
newborn
-Assess patient for
changes in level of
consciousness and
headache throughout
the therapy
-Monitor pain, edema,
ROM of affected
joints.
-Assess affected skin
prior to and daily
during therapy
-Monitor respiratory
status and lung sounds
-Monitor serum
electrolytes
-Promptly report
presence of guaiac
positive stools
-If dose is ordered
daily, administer in the
morning to coincide
with the body’s
normal secretion of
cortisol.
-Administer with
meals to minimize
gastric irritations.
-Instruct the patient to
take the medication
exactly as indicated
and not to skip doses
or double up on

3. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY MECHANISMOF
ACTION
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING CARE CONTRAINDICATION
missed doses
-Encourage the
patient on long-
term therapy to eat
diet high in protein,
calcium and
potassium and low
in sodium and
carbohydrates
-Instruct the patient
to avoid people
with contagious
disease because this
drug causes
immunosuppression
-Caution the patient
to avoid
vaccination without
doctor’s advise
-Instruct the patient
to report severe
abdominal pain,
tarry stools,
unusual swelling,
weight gain, bone
pain, visual
disturbances or
behavior changes

4. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)

5. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY MECHANISMOF
ACTION
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICATION

6. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY MECHANISMOF
ACTION
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICATION