A client with Addison's disease presents to the emergency department. After assessing the client and reviewing laboratory results, the nurse plans to administer high-dose intravenous fluids and high-dose steroids to the client. Which set of findings prompted the nurse's plan?

Nursing management of a client with Addison's disease focuses on recognizing and treating acute adrenal crisis. This condition is life-threatening and is characterized by severe hypotension, electrolyte imbalances, and altered mental status due to inadequate cortisol and aldosterone. In crisis situations, rapid administration of IV fluids and high-dose corticosteroids is required to restore vascular tone and correct metabolic disturbances. Early identification of critical lab and clinical findings guides emergency intervention. Rationale: A. This set of findings indicates an Addisonian crisis. Hypotension (98/56 mmHg) reflects loss of aldosterone leading to sodium and water depletion. Hyperkalemia (K⁺ 6.0 mEq/L) and hyponatremia (Na⁺ 126 mEq/L) are classic electrolyte disturbances due to impaired adrenal hormone function. Confusion indicates cerebral hypoperfusion and worsening systemic instability, requiring immediate IV fluids and corticosteroids. B. Oxygen saturation of 90%, elevated blood pressure (170/98 mmHg), and mildly elevated blood glucose are not characteristic of adrenal crisis. Instead, these findings suggest possible respiratory or cardiovascular stress unrelated to adrenal insufficiency. Hypertension is not typical in Addison’s disease, which usually presents with hypotension. C. Respiratory rate of 22, hypokalemia (K⁺ 2.9 mEq/L), bradycardia (HR 52), and normal glucose do not align with Addisonian crisis. Electrolyte abnormalities are present, but hypokalemia is not typical of adrenal insufficiency, which more commonly causes hyperkalemia. These findings suggest an alternative endocrine or medication-related issue. D. Sodium 148 mEq/L and normal blood pressure (110/74 mmHg) do not reflect adrenal crisis physiology. Addison’s disease typically causes hyponatremia, not hypernatremia. Although weakness and mild temperature elevation may be present in many conditions, this combination does not indicate the need for emergent steroid and fluid replacement.