A client with adrenal insufficiency stopped taking corticosteroids and now has vomiting, severe weakness, and blood pressure 78/42 mm Hg. Which action should the nurse anticipate first?
1Administer IV hydrocortisone and isotonic fluids as prescribed.✓ Correct answer
2Administer an antiemetic and monitor for orthostatic hypotension.
3Initiate a continuous infusion of norepinephrine to raise blood pressure.
4Administer the client's oral corticosteroid dose with water.
Explanation
Vomiting, weakness, and severe hypotension in adrenal insufficiency indicate adrenal crisis. Treatment priorities include glucocorticoid replacement and isotonic fluid resuscitation. Fluid restriction, potassium replacement, or delayed follow-up can worsen shock and electrolyte instability.
Clinical Judgment Use the client cues, timing, labs, and safety risks to select the response that best fits Adrenal crisis after stopping steroids.
Memory Tip Match the strongest cue cluster to the safest nursing judgment.
KR vs US NCLEX items reward cue-based priority thinking rather than isolated recall.
Clinical Practice GuideFor Adrenal crisis after stopping steroids, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.
CautionDo not choose an action from one isolated cue when the full scenario changes priority or safety.