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.
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Related Questions
Correct Answer is D
Explanation
A. Ataxic dysarthria: This is not a common complication associated with Cushing syndrome. It is more related to neurological disorders affecting speech and coordination.
B. Hypotension: Cushing syndrome typically causes hypertension rather than hypotension due to fluid retention and increased vascular resistance.
C. Hyperkalemia: Cushing syndrome is associated with hypokalemia rather than hyperkalemia due to the effects of excess cortisol on potassium levels.
D. Bone fracture: Cushing syndrome increases the risk of osteoporosis and bone fractures due to prolonged exposure to high levels of cortisol, which affects bone density and strength.
Correct Answer is B
Explanation
A. I will need to wear a medical alert bracelet at all times: This statement is correct. Clients with Addison's disease should wear a medical alert bracelet to inform healthcare providers of their condition in case of an emergency, as it could impact treatment decisions.
B. I will need to hold my hydrocortisone dose if I have an infection: This statement indicates a need for additional teaching. Clients with Addison's disease should not hold their hydrocortisone dose if they have an infection. In fact, they may need to increase their dose during periods of stress or illness to manage their condition effectively.
C. I will take my hydrocortisone tablets twice a day: This statement is correct. Hydrocortisone is typically taken in divided doses to mimic the natural release of cortisol from the adrenal glands.
D. I will need to eat a high-sodium diet: This statement is correct. Clients with Addison's disease often need to increase their sodium intake, as they may have difficulties retaining sodium due to adrenal insufficiency.
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