A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?
Explanation & Rationale
A. Infuse 1 unit of platelet: Platelet transfusion is indicated for thrombocytopenia or active bleeding related to low platelet counts. Acute adrenal insufficiency does not involve platelet depletion or coagulation defects. This intervention does not address the underlying hormonal crisis. B. Restrict daily fluid intake: Clients with acute adrenal insufficiency are at risk for hypovolemia and hypotension due to aldosterone deficiency. Fluid restriction would worsen dehydration and circulatory collapse. Fluid replacement is typically required rather than restriction. C. Admin hydrocortisone sodium: Acute adrenal insufficiency requires immediate glucocorticoid replacement to restore cortisol levels. Hydrocortisone sodium provides both glucocorticoid and some mineralocorticoid effects, helping stabilize blood pressure and metabolism. Prompt administration is critical to prevent adrenal crisis complications. D. Give oral spironolactone: Spironolactone is a potassium-sparing diuretic and aldosterone antagonist. In adrenal insufficiency, aldosterone levels are already low, making this medication inappropriate. Its use could worsen hyperkalemia and hypotension.