What are some ethical dilemma warning signs? (Select All that Apply.)

Rationale:
A. Acute renal failure is incorrect because, although kidney dysfunction can affect fluid and electrolyte balance, it is not the primary cause of adrenal crisis. Adrenal crisis results from hormonal insufficiency, not renal failure.

B. Deficiency of corticosteroids is correct because acute adrenal crisis occurs when there is a sudden lack of cortisol, a corticosteroid produced by the adrenal cortex. Cortisol is essential for maintaining blood pressure, glucose metabolism, and the body’s stress response. A deficiency can result from primary adrenal insufficiency (Addison’s disease), secondary adrenal insufficiency (pituitary or hypothalamic dysfunction), or abrupt withdrawal of long-term corticosteroid therapy. This deficiency leads to hypotension, hypoglycemia, electrolyte imbalances (hyponatremia, hyperkalemia), shock, and altered mental status, making it a life-threatening emergency.

C. Overdose of testosterone is incorrect because testosterone does not regulate cortisol or adrenal function and therefore cannot cause adrenal crisis.

D. High doses of corticosteroids are incorrect because, while long-term corticosteroid use can suppress adrenal function, the crisis occurs primarily when the exogenous steroids are abruptly discontinued, leading to insufficient cortisol production. High doses themselves do not precipitate the crisis immediately.

Rationale:
A. Psychosis is incorrect because acute psychotic episodes are uncommon after CCU discharge. While ICU delirium or ICU psychosis may occur during hospitalization, these usually resolve before discharge and are not the most common long-term mental health issue.

B. Social anxiety disorder is incorrect because this is a chronic psychiatric condition unrelated to critical illness or CCU admission. It is not specifically triggered by critical care experiences.

C. Depression is correct because patients often experience post-intensive care syndrome (PICS), which includes depression, anxiety, and cognitive impairments after critical illness. Depression can result from the trauma of illness, prolonged immobilization, sleep deprivation, and the psychological stress of being critically ill, affecting recovery, quality of life, and adherence to post-discharge care.

D. Eating disorders are incorrect because they are usually pre-existing psychiatric conditions and are not commonly developed as a result of CCU hospitalization.