A client with primary adrenal insufficiency has vomiting, hypotension, and confusion. Which action is the priority?
Chart/Exhibit
Choose your responses, then check the answer.
Explanation
Suspected adrenal crisis requires immediate parenteral hydrocortisone and fluid resuscitation; treatment should not wait for confirmatory testing. Hypoglycemia is corrected when present.
Quick answer Treat shock plus inability to retain oral steroid as adrenal crisis.
Why this is correct Cortisol deficiency impairs vascular tone and stress response. Vomiting prevents reliable oral replacement while volume depletion, hyponatremia, hyperkalemia, or hypoglycemia can progress rapidly.
Easy analogy or mental picture Build a medication safety chain: identify the cue cluster, connect it to the drug mechanism, stop preventable exposure, stabilize the client, and verify the response with measurable findings.
NCLEX decision rule Choose the action that prevents the most immediate medication-related harm while preserving treatment for the underlying condition.
Why the other choices are wrong Options that rely on one reassuring value, continue a suspect exposure, bypass monitoring, or delay escalation leave the medication hazard active.
References
1Endocrine Society Guideline: Primary Adrenal InsufficiencyImmediate parenteral hydrocortisone and fluid resuscitation for suspected adrenal crisis before confirmatory results
Medication-safety reviewVerify the indication, current assessment, laboratory trend, timing, route, interactions, authorized action, and measurable follow-up.