In a patient experiencing an Addisonian crisis with laboratory results showing potassium 5.4, sodium 130, calcium 8.0, and blood glucose 70, which medication would the nurse anticipate administering?

In a patient experiencing an Addisonian crisis with laboratory results showing potassium 5.4, sodium 130, calcium 8.0, and blood glucose 70, which medication would the nurse anticipate administering?

• A. insulin
• B. dextrose
• C. H2 histamine blocker
• D. loop diuretic

Answer: (B)

In an Addisonian crisis, cortisol and aldosterone deficiency leads to low blood pressure, hyponatremia, and hyperkalemia, and it can cause hypoglycemia or impaired glucose production. Providing glucose support is essential to protect the brain and heart while you treat the underlying adrenal insufficiency with steroids and fluids. The glucose level here is 70 mg/dL—borderline and at risk during a stressful crisis—so giving dextrose-containing IV fluids helps prevent or treat hypoglycemia and supplies energy quickly, which is critical in this acute setting. Insulin would lower glucose further and isn’t indicated unless there’s severe hyperkalemia or other specific indications; H2 blockers and loop diuretics don’t address the immediate metabolic and hemodynamic needs of an Addisonian crisis. So dextrose-containing therapy is the appropriate choice to support glucose while managing the crisis.

In an Addisonian crisis, cortisol and aldosterone deficiency leads to low blood pressure, hyponatremia, and hyperkalemia, and it can cause hypoglycemia or impaired glucose production. Providing glucose support is essential to protect the brain and heart while you treat the underlying adrenal insufficiency with steroids and fluids. The glucose level here is 70 mg/dL—borderline and at risk during a stressful crisis—so giving dextrose-containing IV fluids helps prevent or treat hypoglycemia and supplies energy quickly, which is critical in this acute setting.

Insulin would lower glucose further and isn’t indicated unless there’s severe hyperkalemia or other specific indications; H2 blockers and loop diuretics don’t address the immediate metabolic and hemodynamic needs of an Addisonian crisis. So dextrose-containing therapy is the appropriate choice to support glucose while managing the crisis.