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 A
Explanation
A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.
B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.
C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.
D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.
Correct Answer is C
Explanation
A. "I will make sure I call the diabetes educator each time I adjust my insulin dose."
This statement suggests a reliance on insulin adjustment and implies frequent contact with the diabetes educator. However, it doesn't address the primary treatment for type 2 diabetes.
B. "I read that a pancreas transplant will provide a cure for my diabetes."
This statement mentions a pancreas transplant, which is a significant and rare intervention typically reserved for severe cases of diabetes. However, it's not considered the primary treatment for type 2 diabetes.
C. "I will make sure to follow the weight loss plan designed by the dietitian."
This statement aligns with a key aspect of managing type 2 diabetes, as weight management, along with diet and exercise, is a primary approach. Lifestyle modifications, including weight loss, are often part of the primary treatment plan.
D. "I will take my oral anti-diabetic agents when my morning blood sugar is high."
This statement indicates an understanding of the importance of oral anti-diabetic agents, which are commonly used in the management of type 2 diabetes. Timing medication based on blood sugar levels is a key aspect of treatment.
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