What is a critical instruction the nurse should provide to parents of a child on high-dose prednisone for asthma?

When a child is prescribed high-dose prednisone for asthma, one critical instruction for parents is that the medication should be stopped gradually. Prednisone is a corticosteroid that can suppress the hypothalamic-pituitary-adrenal (HPA) axis, particularly when used at high doses or for prolonged periods. Abruptly discontinuing the medication can lead to adrenal insufficiency, a potentially serious condition where the body is unable to produce enough cortisol. A gradual tapering of the dose allows the adrenal glands to resume normal function and helps to prevent withdrawal symptoms.

Taking the medication with food is also a common practice to minimize gastrointestinal irritation, but it does not address the critical concern of safely discontinuing prednisone. Similarly, stopping the medication suddenly can be dangerous and needs to be avoided. Although monitoring weight is important due to potential side effects of prednisone, it is not as critical as the need to taper the dosage correctly to prevent adrenal crisis. Therefore, the importance of gradually reducing the dose stands out as a key instruction for parents.