For planning care of a patient with acute adrenal insufficiency, which hormone deficit guides the interventions?

For planning care of a patient with acute adrenal insufficiency, which hormone deficit guides the interventions?

• A. Cortisol
• B. Aldosterone
• C. Antidiuretic hormone
• D. Thyroid-stimulating hormone

Answer: (A)

In an acute adrenal crisis, the most important deficit is cortisol. Cortisol is essential for maintaining vascular tone, responding to stress, and supporting glucose metabolism. When cortisol is lacking, patients often become hypotensive and hypoglycemic and don’t respond adequately to fluids alone. That’s why the immediate treatment centers on glucocorticoid replacement—typically giving a stress-dose of hydrocortisone IV. Hydrocortisone provides both glucocorticoid and some mineralocorticoid activity, helping stabilize blood pressure and support electrolyte balance while you address fluids and glucose urgently. Aldosterone deficiency also contributes to volume depletion and electrolyte disturbances, but the pivotal intervention in the crisis is replacing cortisol, which drives the hemodynamic instability. Antidiuretic hormone and thyroid-stimulating hormone are not the deficits guiding acute management here.

In an acute adrenal crisis, the most important deficit is cortisol. Cortisol is essential for maintaining vascular tone, responding to stress, and supporting glucose metabolism. When cortisol is lacking, patients often become hypotensive and hypoglycemic and don’t respond adequately to fluids alone. That’s why the immediate treatment centers on glucocorticoid replacement—typically giving a stress-dose of hydrocortisone IV. Hydrocortisone provides both glucocorticoid and some mineralocorticoid activity, helping stabilize blood pressure and support electrolyte balance while you address fluids and glucose urgently.

Aldosterone deficiency also contributes to volume depletion and electrolyte disturbances, but the pivotal intervention in the crisis is replacing cortisol, which drives the hemodynamic instability. Antidiuretic hormone and thyroid-stimulating hormone are not the deficits guiding acute management here.