A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

Reasoning:

Choice A reason: Defective production of erythrocytes is a key classification of anemia, as seen in conditions like aplastic anemia or iron deficiency anemia. Impaired bone marrow function or nutrient deficiencies reduce red blood cell synthesis, leading to decreased hemoglobin and oxygen-carrying capacity, a common mechanism in various anemias.

Choice B reason: Destruction of erythrocytes, or hemolysis, is a major anemia classification. Conditions like hemolytic anemia cause premature red blood cell breakdown due to immune-mediated destruction, membrane defects, or hemoglobinopathies, reducing circulating erythrocytes and causing anemia despite normal or increased bone marrow production.

Choice C reason: Loss of erythrocytes through bleeding is a primary anemia classification. Chronic or acute blood loss from gastrointestinal, genitourinary, or traumatic sources depletes red blood cells and iron stores, leading to iron deficiency anemia, a common cause, particularly in older adults or those with chronic bleeding.

Choice D reason: Shape of erythrocytes is not a primary classification for anemia. While abnormal shapes, like sickle cells, contribute to specific anemias (e.g., sickle cell anemia), classification focuses on mechanisms like production, destruction, or loss. Shape is a characteristic, not a primary cause of anemia.

Choice E reason: Quantity of erythrocytes is a consequence, not a classification, of anemia. All anemias involve reduced erythrocyte counts, but the classification is based on underlying causes—defective production, destruction, or loss—not the resulting low quantity, which is a defining feature rather than a mechanistic category.

Reasoning:

Choice A reason: Third-spacing and hyperthermia are not typical of autonomic dysreflexia, a condition in spinal cord injury causing sympathetic overactivity. Third-spacing occurs in fluid shifts like edema, and hyperthermia suggests infection, not the autonomic response to stimuli like bladder distension triggering dysreflexia.

Choice B reason: Autonomic dysreflexia, common in spinal cord injuries above T6, causes bradycardia and hypertension. Noxious stimuli (e.g., bladder distension) trigger sympathetic overactivity, raising blood pressure, while baroreceptors stimulate vagal response, slowing heart rate, making these classic manifestations of this life-threatening condition.

Choice C reason: Tachycardia and agitation may occur in other conditions but are not primary in autonomic dysreflexia. Hypertension triggers a compensatory bradycardia, not tachycardia, and while agitation may accompany distress, the hallmark is the cardiovascular response, making this less accurate.

Choice D reason: Respiratory distress and projectile vomiting are not primary manifestations of autonomic dysreflexia. While severe hypertension may cause nausea, the classic signs are bradycardia and hypertension due to sympathetic overactivity from stimuli below the spinal injury, not respiratory or vomiting issues.