A client has a serum potassium level of 2.9 mEq/L. Which action prescribed by the health care provider should the nurse take first?

Choice A reason: I will always need to take hydrocortisone pills is a correct statement. Hydrocortisone is a synthetic form of cortisol, a hormone that is normally produced by the adrenal glands. After a bilateral adrenalectomy, the patient will have no adrenal glands and will need to take hydrocortisone pills for life to replace the missing hormone.

Choice B reason: I have a way to inject hydrocortisone in case of emergency is also a correct statement. Hydrocortisone injections are used to treat acute adrenal crisis, a life-threatening condition that can occur when the patient has low cortisol levels due to stress, illness, injury, or surgery. The patient should have an emergency kit with hydrocortisone injections and instructions on how to use them.

Choice C reason: I will stop taking hydrocortisone when I feel better is an incorrect statement. This indicates a need for further education regarding medications after a bilateral adrenalectomy. The patient should never stop taking hydrocortisone without consulting their doctor, as this can cause severe symptoms of adrenal insufficiency, such as low blood pressure, low blood sugar, weakness, fatigue, and confusion.

Choice D reason: I have nausea or vomiting often is a statement that requires further assessment by the nurse. Nausea or vomiting can be signs of inadequate or excessive hydrocortisone dosage, or other complications after a bilateral adrenalectomy. The nurse should monitor the patient's vital signs, blood glucose, electrolytes, and weight, and report any abnormal findings to the doctor. The patient may need to adjust their hydrocortisone dose or take other medications to manage their symptoms.

Choice A reason: Weight loss is a common clinical manifestation of type 1 diabetes mellitus in children. Type 1 diabetes mellitus is a condition where the pancreas does not produce enough insulin, a hormone that helps the cells use glucose for energy. Without insulin, the glucose stays in the blood and causes high blood sugar levels. The body then breaks down fat and muscle for energy, resulting in weight loss.

Choice B reason: Low urine output is not a typical clinical manifestation of type 1 diabetes mellitus in children. In fact, the opposite is true: high urine output is a sign of type 1 diabetes mellitus. This is because the excess glucose in the blood draws water from the cells and tissues, causing dehydration and increased thirst. The kidneys then try to flush out the glucose and water through urine, leading to frequent urination.

Choice C reason: Weight gain is not a usual clinical manifestation of type 1 diabetes mellitus in children. As explained in choice A, type 1 diabetes mellitus causes weight loss due to the lack of insulin and the breakdown of fat and muscle. Weight gain can be a sign of type 2 diabetes mellitus, which is a condition where the cells become resistant to insulin and the pancreas cannot produce enough insulin to overcome the resistance. Weight gain can also be a side effect of insulin therapy, which is used to treat both types of diabetes mellitus.

Choice D reason: Hand tremors are not a specific clinical manifestation of type 1 diabetes mellitus in children. Hand tremors can be caused by many factors, such as anxiety, stress, caffeine, medication, or neurological disorders. Hand tremors can also be a symptom of hypoglycemia, which is a condition of low blood sugar that can occur in people with diabetes mellitus. However, hypoglycemia is not exclusive to diabetes mellitus, and can affect anyone who has a low intake of food, a high expenditure of energy, or a high dose of insulin or oral hypoglycemic agents.