A 45-year-old male patient presents to the emergency department with complaints of fatigue, muscle weakness, and weight loss. Upon examination, he is noted to have hyperpigmentation of the skin and hypotension. Laboratory tests reveal hyponatremia and hyperkalemia. Based on these findings, the patient is diagnosed with Addison’s disease. Which interventions should the nurse anticipate for the management of this patient? (Select All that Apply.)

Choice A Reason:

Macular degeneration primarily affects central vision and is characterized by a gradual loss of vision rather than sudden symptoms. It does not typically cause flashes of light, shadows over the visual field, or floaters. These symptoms are more indicative of a retinal issue.

Choice B Reason:

Cataracts cause clouding of the lens, leading to blurred vision and difficulty seeing at night. However, they do not cause sudden flashes of light, shadows over the visual field, or floaters. Cataracts develop gradually and do not present with acute symptoms.

Choice C Reason:

Glaucoma is associated with increased intraocular pressure, which can lead to gradual loss of peripheral vision. While acute angle-closure glaucoma can cause sudden symptoms, it typically presents with severe eye pain, headache, and nausea, rather than flashes of light and floaters.

Choice D Reason:

Retinal detachment is characterized by the sudden onset of flashes of light, floaters, and a shadow or curtain over the visual field. These symptoms occur because the retina is pulling away from its normal position, which can lead to vision loss if not treated promptly. Immediate medical attention is required to prevent permanent vision loss.

Choice A Reason:

Allowing the client to keep her hearing aids in is crucial for effective communication between the nurse and the client. Hearing aids help the client understand instructions and respond appropriately, which is essential for ensuring the client’s safety and comfort before surgery. According to preoperative guidelines, patients with hearing impairments should be allowed to use their hearing aids until they are taken to the operating room. This practice helps reduce anxiety and ensures that the client can hear and understand all preoperative instructions and consent information.

Choice B Reason:

Allowing the client to consume clear liquids up to the time of surgery is generally not recommended. Preoperative fasting guidelines typically require patients to stop consuming clear liquids at least two hours before surgery to reduce the risk of aspiration during anesthesia. Therefore, this option is not appropriate for ensuring the client’s safety.

Choice C Reason:

Allowing the client to take her morning vitamins is not advisable without specific instructions from the surgical team. Some vitamins and supplements can interact with anesthesia or increase the risk of bleeding during surgery. It is essential to follow the surgical team’s guidelines regarding medication and supplement intake before surgery.

Choice D Reason:

Allowing the client to keep her tongue stud in is not recommended. All jewelry and body piercings should be removed before surgery to prevent complications such as electrical burns during the use of electrocautery devices or interference with airway management. Removing the tongue stud is necessary to ensure the client’s safety during the procedure.