Page 1384 - Saunders Comprehensive Review For NCLEX-RN

a. Monitor vital signs (particularly for
hypotension), for weight loss, and
intake and output.
b. Monitor white blood cell (WBC) count;
blood glucose; and potassium, sodium,
and calcium levels.
c. Administer glucocorticoid and/or
mineralocorticoid medications as
prescribed.
d. Observe for addisonian crisis caused by
stress, infection, trauma, or surgery.

7. Client education

a. Need for lifelong glucocorticoid
replacement and possibly lifelong
mineralocorticoid replacement.
b. Corticosteroid replacement will need to
be increased during times of stress.
c. Avoid individuals with an infection.
d. Avoid strenuous exercise and stressful
situations.
e. Avoid over-the-counter medications.
f. Diet should be high in protein and
carbohydrates; clients taking
glucocorticoids should be prescribed
calcium and vitamin D supplements to
maintain normal levels and to protect
against corticosteroid-induced
osteoporosis; some clients taking
mineralocorticoids may be prescribed
a diet high in sodium.
g. Wear a MedicAlert bracelet.
h. Report signs and symptoms of
complications, such as
underreplacement and
overreplacement of corticosteroid
hormones.
B. Addisonian crisis
1. Description (Box 46-8)
2. Assessment
a. Severe headache
b. Severe abdominal, leg, and lower back
pain
c. Generalized weakness
d. Irritability and confusion
e. Severe hypotension
f. Shock
3. Interventions

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