A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?
Methylprednisolone (Solu-medrol)
Hypotonic saline
Potassium (K-dur)
Regular Insulin
The Correct Answer is A
A. Methylprednisolone (Solu-medrol):
Explanation: Acute adrenal insufficiency is a life-threatening condition characterized by a sudden deficiency of adrenal hormones. In this situation, intravenous glucocorticoids such as methylprednisolone are administered to replace the deficient hormones and stabilize the patient. This is the appropriate intervention to address the acute adrenal crisis.
B. Hypotonic saline:
Explanation: Hypotonic saline is not the first-line treatment for acute adrenal insufficiency. The priority is to replace glucocorticoids to address the adrenal hormone deficiency.
C. Potassium (K-dur):
Explanation: While electrolyte imbalances can occur in adrenal insufficiency, potassium replacement alone does not address the primary issue of glucocorticoid deficiency in acute adrenal insufficiency.
D. Regular Insulin:
Explanation: Regular insulin is not the primary treatment for acute adrenal insufficiency. Glucocorticoid replacement, such as methylprednisolone, is the key intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Buffalo hump:
Explanation: A buffalo hump is associated with excess cortisol, which is not a typical manifestation of Addison's disease. Instead, patients with Addison's disease may experience weight loss and muscle wasting.
B. Hyponatremia:
Explanation: Correct. Hyponatremia (low sodium levels) can occur in Addison's disease due to the loss of aldosterone, which plays a role in sodium and water balance.
C. Decreased glucose level:
Explanation: Correct. Addison's disease can lead to hypoglycemia (low blood glucose levels) because cortisol, which is important for maintaining blood glucose, is deficient.
D. Weight gain:
Explanation: Weight gain is not a typical manifestation of Addison's disease. Instead, weight loss and muscle wasting may occur.
E. Craving for salt:
Explanation: Correct. Addison's disease can lead to salt craving, as aldosterone deficiency results in increased sodium loss and potassium retention.
Correct Answer is C
Explanation
A. pH 7.28, pCO2 36, HCO3 23:
Explanation: The pH is low, indicating acidosis. However, the pCO2 is within the normal range, which is not consistent with respiratory acidosis. The HCO3 is slightly low but not significantly, and this doesn't align with typical findings in respiratory acidosis.
B. pH 7.52, pCO2 28, HCO3 25:
Explanation: The pH is high, indicating alkalosis. The pCO2 is below the normal range, which is not consistent with respiratory acidosis. The HCO3 is within the normal range, and these values are not typical for respiratory acidosis.
C. pH 7.25, pCO2 50, HCO3 22:
Explanation: The pH is low, indicating acidosis. The pCO2 is elevated, which is typical in respiratory acidosis. The HCO3 is within the normal range, suggesting uncompensated respiratory acidosis.
D. pH 7.35, pCO2 40, HCO3 24:
Explanation: The pH is within the normal range, and both pCO2 and HCO3 are normal. These values do not indicate acidosis.
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