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A client with adrenal insufficiency is brought into the ED where you practice nursing. The client is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include which of the following?

a) Observe for signs of hypernatremia and hyperkalemia in clients experiencing adrenal crisis.
b) Observe for signs of hyponatremia and hypokalemia.
c) Observe for signs of hyponatremia and hyperkalemia.
d) Observe for signs of hypernatremia and hypokalemia in clients experiencing adrenal crisis.

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Final answer:

The nursing management of a client with adrenal insufficiency presenting in the emergency department would include observing for signs of hyponatremia (decreased blood sodium levels) and hyperkalemia (elevated blood potassium levels).

Step-by-step explanation:

The nursing management of a client with adrenal insufficiency presenting in the emergency department would include observing for signs of hyponatremia (decreased blood sodium levels) and hyperkalemia (elevated blood potassium levels). Adrenal insufficiency, also known as Addison's disease, is characterized by reduced production of cortisol from the adrenal gland. Patients with adrenal crisis may experience severe symptoms such as nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. Extreme stress, like strenuous yard work, can trigger an adrenal crisis causing abdominal pain, vomiting, and severe hypotension. Therefore, it is important for the nurse to be vigilant for signs of electrolyte imbalances, specifically hyponatremia and hyperkalemia, which can occur during adrenal crisis.

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