For which client is fludrocortisone indicated?
Explanation & Rationale
A. A client with fluid retention and edema: Fludrocortisone has strong mineralocorticoid effects that promote sodium and water retention. This would worsen edema and increase intravascular volume. It is contraindicated in clients with existing fluid overload. B. A client with Addison's disease: Addison’s disease involves deficient adrenal production of cortisol and aldosterone. Fludrocortisone replaces aldosterone by enhancing sodium reabsorption and potassium excretion. It is used to maintain blood pressure and electrolyte balance in primary adrenal insufficiency. C. A client with chronic kidney disease: Fludrocortisone can cause sodium retention and potassium loss, increasing the risk of hypertension and electrolyte imbalance in impaired renal function. Chronic kidney disease limits the ability to safely handle these effects. It is not routinely indicated in this population. D. A client with type 2 diabetes: Fludrocortisone may increase blood glucose levels due to its glucocorticoid activity. It does not treat insulin resistance or pancreatic dysfunction. Diabetes alone is not an indication.