A client diagnosed with acute glomerulonephritis has pitting edema in both feet, and has had 300 mL of urine output in the last 24 hours. The nurse should monitor this client for which complication associated with this finding?

A. Fluid volume deficit, or dehydration, occurs when the body loses more fluid than it takes in. In this case, the patient has very low urine output, indicating that the kidneys are not excreting enough fluid. Despite the low urine output, the presence of pitting edema suggests that the patient is actually retaining fluid rather than losing it.
B. Bradycardia is defined as a heart rate slower than 60 beats per minute. While electrolyte imbalances and fluid imbalances can affect heart rate, bradycardia is not the primary concern associated with the combination of pitting edema and low urine output in this situation.
C. Hypertension (high blood pressure) is a common complication in acute glomerulonephritis. The condition often leads to fluid retention due to reduced kidney function and increased sodium and fluid retention. The presence of pitting edema and very low urine output suggests that the kidneys are not effectively removing excess fluid, which can lead to increased blood pressure.
D. Hyperglycemia refers to elevated blood glucose levels. Acute glomerulonephritis is not directly associated with hyperglycemia. While patients with diabetes can develop renal issues, hyperglycemia itself is not a typical direct complication of acute glomerulonephritis.

A. Furosemide is a loop diuretic used to treat fluid overload by increasing urine output. In an Addisonian crisis, the primary issue is the severe lack of adrenal hormones rather than fluid overload. Administering furosemide is not indicated in this situation, as it does not address the underlying cause of the crisis or correct electrolyte imbalances that are common in Addisonian crisis.
B. This is a common intravenous fluid choice for managing Addisonian crisis. The 0.9% sodium chloride (normal saline) helps to restore blood volume and correct electrolyte imbalances, while the 5% dextrose provides glucose to support energy needs. This combination helps to address hypovolemia (low blood volume) and prevent hypoglycemia (low blood sugar), both of which can occur in an adrenal crisis.

C. Ketoconazole is an antifungal medication that can be used to treat Cushing’s syndrome, not Addisonian crisis. Insulin is used to manage blood glucose levels and would not be the primary treatment for Addisonian crisis. This option does not directly address the adrenal insufficiency or the immediate needs of an Addisonian crisis.
D. Addisonian crisis often presents with hyponatremia (low sodium) and hyperkalemia (high potassium) due to inadequate aldosterone production. Administering potassium chloride could exacerbate hyperkalemia, which is a concern in Addisonian crisis. Therefore, potassium chloride infusion is not appropriate and could worsen the electrolyte imbalance.