A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?
Methylprednisolone (Solu-medrol)
Hypotonic saline
Potassium (K-dur)
Regular Insulin
The Correct Answer is A
A. Methylprednisolone (Solu-medrol):
Explanation: Acute adrenal insufficiency is a life-threatening condition characterized by a sudden deficiency of adrenal hormones. In this situation, intravenous glucocorticoids such as methylprednisolone are administered to replace the deficient hormones and stabilize the patient. This is the appropriate intervention to address the acute adrenal crisis.
B. Hypotonic saline:
Explanation: Hypotonic saline is not the first-line treatment for acute adrenal insufficiency. The priority is to replace glucocorticoids to address the adrenal hormone deficiency.
C. Potassium (K-dur):
Explanation: While electrolyte imbalances can occur in adrenal insufficiency, potassium replacement alone does not address the primary issue of glucocorticoid deficiency in acute adrenal insufficiency.
D. Regular Insulin:
Explanation: Regular insulin is not the primary treatment for acute adrenal insufficiency. Glucocorticoid replacement, such as methylprednisolone, is the key intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
A. Asthma:
Explanation: Asthma is associated with respiratory alkalosis, not respiratory acidosis. In asthma, there is often hyperventilation leading to a decrease in carbon dioxide levels.
B. Hyperventilation:
Explanation: Correct. Hyperventilation can cause respiratory alkalosis, not respiratory acidosis. It leads to a decrease in carbon dioxide levels.
C. Chronic obstructive pulmonary disease (COPD):
Explanation: Correct. Conditions like COPD can lead to respiratory acidosis. In COPD, there is impaired ventilation, leading to an accumulation of carbon dioxide.
D. Renal insufficiency:
Explanation: Renal insufficiency is not a direct cause of respiratory acidosis. Respiratory acidosis is primarily related to respiratory system dysfunction.
E. Pneumonia:
Explanation: Correct. Pneumonia can cause respiratory acidosis. In pneumonia, there may be difficulty in eliminating carbon dioxide due to impaired gas exchange.
Correct Answer is B
Explanation
A.Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.
B.Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.
C.Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.
D.Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.
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