Which manifestation would the nurse anticipate finding in a patient diagnosed with adrenal insufficiency?

Which manifestation would the nurse anticipate finding in a patient diagnosed with adrenal insufficiency?

• A. Vitiligo
• B. Hyperkalemia
• C. Hyperpigmentation
• D. Hypertension

Answer: (C)

Adrenal insufficiency, especially primary adrenal failure, raises ACTH levels because cortisol production is too low. The ACTH precursor POMC also yields melanocyte-stimulating hormone, which stimulates pigment production in the skin. The resulting hyperpigmentation is a characteristic sign, often seen in sun-exposed areas, skin folds, scars, and mucous membranes. This happens more with primary adrenal failure when ACTH is high; in secondary adrenal insufficiency ACTH may be low or normal, so hyperpigmentation is less expected. While low aldosterone can cause hyperkalemia and hypotension, and vitiligo is a separate autoimmune process, the distinctive darkening of the skin is the most consistent finding you’d anticipate.

Adrenal insufficiency, especially primary adrenal failure, raises ACTH levels because cortisol production is too low. The ACTH precursor POMC also yields melanocyte-stimulating hormone, which stimulates pigment production in the skin. The resulting hyperpigmentation is a characteristic sign, often seen in sun-exposed areas, skin folds, scars, and mucous membranes. This happens more with primary adrenal failure when ACTH is high; in secondary adrenal insufficiency ACTH may be low or normal, so hyperpigmentation is less expected. While low aldosterone can cause hyperkalemia and hypotension, and vitiligo is a separate autoimmune process, the distinctive darkening of the skin is the most consistent finding you’d anticipate.