A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

A. Spinach is known to be high in oxalates. Oxalates are compounds that can bind with calcium in the urine, forming calcium oxalate stones, which are the most common type of kidney stones. For clients with a history of kidney stones related to high oxalate intake, it is crucial to limit or avoid high-oxalate foods such as spinach to reduce the risk of further stone formation.
B. Anchovies are not particularly high in oxalates. They are more commonly associated with other nutritional considerations, such as being a good source of omega-3 fatty acids and protein. While anchovies are not a significant source of oxalates, they are not a primary concern for those needing to manage oxalate intake.
C. Organ meats, such as liver and kidneys, are not known for high oxalate content. They are high in other nutrients and substances but do not significantly contribute to oxalate levels in the urine. Therefore, avoiding organ meats is not typically necessary for managing oxalate levels.
D. Milk is not high in oxalates. In fact, dairy products are a good source of calcium, which can help bind oxalates in the gut and reduce their absorption. For individuals managing oxalate levels, increasing calcium intake from dairy products can be beneficial. Milk and other dairy products are generally not restricted in a diet aimed at reducing oxalate intake.

A. Hypernatremia (elevated sodium levels) is not a common sign of Addisonian crisis. In Addisonian crisis, the lack of aldosterone leads to sodium loss, which often results in hyponatremia (low sodium levels) rather than hypernatremia. The patient might also experience dehydration and electrolyte imbalances, but hypernatremia is not typical in this scenario.
B. Fluid volume overload is not characteristic of Addisonian crisis. Instead, Addisonian crisis often leads to fluid volume deficit due to the loss of aldosterone, which impairs sodium and water retention. This can result in dehydration and low blood volume rather than fluid overload.
C. Hypokalemia (low potassium levels) is not typically associated with Addisonian crisis. In fact, the lack of aldosterone in Addisonian crisis leads to potassium retention, resulting in hyperkalemia (elevated potassium levels). Therefore, monitoring for hypokalemia is not relevant in the context of Addisonian crisis following a bilateral adrenalectomy.
D. Hypoglycemia (low blood glucose levels) is a key sign of Addisonian crisis. Cortisol plays a crucial role in glucose metabolism and maintaining blood glucose levels. With the loss of cortisol production after a bilateral adrenalectomy, patients may experience hypoglycemia, which can be a critical indicator of Addisonian crisis.