How is Addison disease treated and clinically managed?

1. Ensure MDHCP has discussed risks and benefits of blood transfusion. (a)
2. Educate patient on signs and symptoms of transfusion reaction. (d)
3. Obtain cross match and send it to blood bank. (b)
4. Gain blood from bank, confirm correct patient, correct product, correct cross match with 2 RNs. (e)
5. Initiate transfusion through a large gauge IV per hospital protocol. (c)
6. Start transfusion slowly for the first 15 minutes and stay with patient for the first 15 minutes. (f)
7. Increase rate of transfusion and monitor patient frequently. (g)
8. Ensure transfusion is complete within 4 hours of starting. (h)
9. Continue to monitor patient for transfusion reaction for 24 hours following transfusion. (i)

Rationale:

1. Ensure MDHCP has discussed risks and benefits of blood transfusion: It's essential that the healthcare provider discusses with the patient the potential risks and benefits of receiving a blood transfusion. This step is crucial for informed consent.
2. Educate patient on signs and symptoms of transfusion reaction: Before starting the transfusion, the patient should be educated on what signs and symptoms to watch out for that might indicate an adverse reaction, such as fever, chills, hives, or shortness of breath.
3. Obtain cross match and send it to blood bank: A blood sample is taken from the patient to determine their blood type and to perform a crossmatch, which ensures that the donor blood is compatible with the patient's blood.
4. Gain blood from bank, confirm correct patient, correct product, correct cross match with 2 RNs: Once the blood is ready, two registered nurses (RNs) will verify the patient's identity, the blood product, and the crossmatch results to ensure everything is correct before proceeding.
5. Initiate transfusion through a large gauge IV per hospital protocol: The blood transfusion is started using a large gauge intravenous (IV) line, as per hospital protocols to ensure proper flow and reduce complications.
6. Start transfusion slowly for the first 15 minutes and stay with patient for the first 15 minutes: The transfusion is started at a slow rate to monitor for any immediate adverse reactions. The healthcare provider stays with the patient during this time to closely observe them.
7. Increase rate of transfusion and monitor patient frequently: If no adverse reactions are noted in the first 15 minutes, the rate of transfusion can be increased. The patient is monitored frequently throughout the transfusion for any signs of a reaction.
8. Ensure transfusion is complete within 4 hours of starting: Blood products should be transfused within 4 hours to minimize the risk of bacterial growth and to ensure the effectiveness of the transfusion.
9. Continue to monitor patient for transfusion reaction for 24 hours following transfusion: After the transfusion is complete, the patient is monitored for at least 24 hours for any delayed transfusion reactions, such as fever, allergic reactions, or other complications.

Choice A reason: Monitoring potassium levels is essential for various medical conditions, but it is not specifically used to evaluate the effects of therapy for acute pancreatitis. Potassium levels may be monitored to assess overall electrolyte balance and kidney function, but they do not provide direct information about pancreatic inflammation or damage.
Choice B reason: Monitoring lipase levels is crucial in evaluating the effects of therapy for a patient with acute pancreatitis. Lipase is an enzyme produced by the pancreas, and its levels rise significantly during an acute episode of pancreatitis. Elevated lipase levels are a sensitive and specific indicator of pancreatic inflammation and damage. By regularly measuring lipase levels, healthcare providers can assess the severity of the condition, monitor the patient's response to treatment, and make necessary adjustments to the therapeutic regimen.
Choice C reason: Calcium levels are not typically used to evaluate the effects of therapy for acute pancreatitis. Although hypercalcemia (high calcium levels) can be a risk factor for developing pancreatitis, monitoring calcium levels is not a standard method for assessing the effectiveness of treatment for the condition.
Choice D reason: Bilirubin levels are not directly related to the evaluation of therapy for acute pancreatitis. Bilirubin is a breakdown product of hemoglobin and is primarily used to assess liver function and diagnose conditions such as jaundice or liver disease. While liver function tests may be performed in patients with pancreatitis to rule out concurrent liver issues, bilirubin levels alone do not provide information about the effectiveness of therapy for pancreatitis.