A client with a history of adrenal insufficiency is admitted to the intensive care unit with an acute adrenal crisis. The client is complaining of nausea and joint pain. Vital signs are: temperature 102° F (38.9° C), heart rate 138 beats/minute, blood pressure 80/60 mm Hg. Which intervention should the nurse implement first?

A. Cover client with cooling blanket. This could help manage the fever but is not the highest priority in the context of acute adrenal crisis. B. Obtain an analgesic prescription. Pain management is important, but it is not the immediate priority in a life-threatening adrenal crisis. C. Infuse an intravenous fluid bolus. This is the correct answer because the client is experiencing hypotension (low blood pressure), which is critical in an acute adrenal crisis. IV fluids are essential to restore blood pressure and perfusion. D. Administer PRN oral antipyretic. Managing the fever is important, but not the first priority. The client’s hemodynamic instability needs to be addressed immediately.