A patient with Addison disease is experiencing weakness and ...

[ARLKQ]

A patient with Addison disease is experiencing weakness and abdominal pain and has an oral temperature of 102F and blood pressure of 70/35. Which patient information should the nurse identify as potentially causing these manifestations?
 
  Select all that apply.
  1. I had my tonsils out last week.
  2. I have a pressure ulcer from sleeping in my recliner.
  3. I have been using a tanning bed.
  4. I take my prednisone (Deltasone) every day.
  5. I have been increasing my intake of calcium-rich foods.

Question 2

The nurse is reviewing information in the medical record of a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of these manifestations should the nurse investigate first when assessing this patient?
 
  Laboratory report:
  Serum sodium 115 mEq/L
  History and physical:
  Patient reports fell from bicycle and struck head 5 days ago
  Pulse:
  100
  Blood pressure:
  140/95
  Previous 24-hour intake and output:
  3,500 mL in, 1,500 mL out
 
  1. The patient is lethargic and difficult to wake.
  2. The patient states, I feel thirsty.
  3. The patient states, I have a headache.
  4. The patient's urine is dark amber in color.

[yifu223]

Answer to Question 1

Correct Answer: 1,2
Addisonian crisis is a life-threatening response to acute adrenal insufficiency. Triggers are surgery, acute systemic illness such as sepsis from a pressure ulcer, trauma, or abrupt withdrawal of long-term corticosteroid therapy. Patients are prescribed prednisone or related glucocorticoids to treat Addison disease; this is not a cause of Addisonian crisis. Intake of calcium-rich foods and the use of tanning beds are not associated with Addisonian crisis.

Answer to Question 2

Correct Answer: 1
Manifestations of SIADH are usually nonspecific but are related to hyponatremia and water intoxication. SIADH may occur with a head injury. Cerebral edema develops, causing changes in mental status such as lethargy. Despite fluid retention, the patient may experience thirst. Headache and dark urine are common symptoms of this disorder.