46. Which is the most common treatment for a client in addisonian crisis?
. IV normal saline and glucocorticoids.
. IV lactated Ringer's and packed cells.
. IV 5% dextrose in normal saline and dopamine.
. IV total parenteral nutrition (TPN) and insulin coverage.
Test-Taking Tip
Addison's disease is a deficiency of glucocorticoids—note that the correct answer has the word "glucocorticoid."
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Fluid and Electrolyte Imbalances
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Answer 1 is correct because immediate treatment is directed toward reversing circulatory shock of addisonian crisis. Replacement of sodium and the missing steroid hormones is critical. Answer 2 is incorrect because the client needs sodium and an increased volume. Answer 3 is incorrect because initial treatment is normal saline. D5NS may be given with the glucocorticoids; however, a vasopressor such as dopamine would not be the first line of treatment. Answer 4 is incorrect because the primary problem is circulatory shock.