A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?
IV hydrocortisone
Ketoconazole and insulin
Lactated Ringer's IV infusion
Furosemide slow IV push
The Correct Answer is A
A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.
Correct Answer is B
Explanation
A. Excess mineralocorticoids: Mineralocorticoids primarily affect electrolyte and fluid balance. While excess mineralocorticoids can cause hypertension and fluid retention, they are not directly responsible for hirsutism or acne.
B. Excess adrenal androgens: Cushing syndrome can lead to elevated levels of adrenal androgens, which are responsible for hirsutism (excessive hair growth) and acne due to their androgenic effects.
C. Excess thyroid hormone: Thyroid hormone imbalances can affect various body systems, but they are not directly related to the development of hirsutism or acne seen in Cushing syndrome.
D. Excess glucocorticoids: While excess glucocorticoids are characteristic of Cushing syndrome and can cause a range of symptoms, hirsutism and acne are specifically due to excess adrenal androgens rather than glucocorticoids.
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