長期使用皮質類固醇可能有哪些副作用？（選所有適合的）

核心概念：長期使用皮質類固醇（corticosteroids）的潛在副作用。 為什麼正確答案 A, B, D, E 對： A. 皮質類固醇會促進肝臟糖質新生（gluconeogenesis）並降低周邊組織對胰島素的敏感性，導致血糖升高（hyperglycemia），增加糖尿病或使既有糖尿病惡化的風險。 B. 長期使用會抑制鈣質吸收，增加骨質流失速度，並可能影響維生素 D 的代謝，進而導致骨質疏鬆症（osteoporosis）。 D. 皮質類固醇具有免疫抑制作用，會削弱身體抵抗感染的能力，使病人更容易發生各種感染，且感染可能更為嚴重。 E. 皮質類固醇會促進鈉離子和水分的滯留，導致體液積聚，引起水腫（edema）和體重增加。 為什麼其他選項錯： C. 體重減輕（weight loss）並非長期使用皮質類固醇的典型副作用。相反地，由於水腫和食慾增加，病人通常會體重增加，甚至出現向心性肥胖（central obesity）。 臨床思路：此題評估對藥物副作用的理解。皮質類固醇是廣泛使用的抗發炎藥物，但其全身性影響深遠。護理師需了解其對血糖、骨骼、免疫及體液平衡的影響，以便監測病人並提供適當的衛教。

Core concept: potential adverse effects of long-term corticosteroid therapy. Why the correct answers A, B, D, E are right: A. Corticosteroids promote hepatic gluconeogenesis and reduce peripheral tissue sensitivity to insulin, resulting in elevated blood glucose (hyperglycemia) and increasing the risk of developing or worsening diabetes mellitus. B. Long-term use inhibits calcium absorption, accelerates bone loss, and may interfere with vitamin D metabolism, ultimately leading to osteoporosis. D. Corticosteroids exert an immunosuppressive effect, weakening the body's defense against infection. Clients become more susceptible to infections, which may also be more severe. E. Corticosteroids promote sodium and water retention, causing fluid accumulation, edema, and weight gain. Why the other option is wrong: C. Weight loss is not a typical adverse effect of long-term corticosteroid use. On the contrary, due to edema and increased appetite, clients usually gain weight and may develop central obesity. Clinical reasoning: This item assesses understanding of medication side effects. Corticosteroids are widely used anti-inflammatory agents, but their systemic effects are far-reaching. The nurse must understand their impact on blood glucose, bone, immunity, and fluid balance in order to monitor clients and provide appropriate education.