Reduction of Risk Potential Q 5

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Nurse Zeny is caring for a client in an acute Addisonian crisis. Which laboratory data would the nurse expect to find?

  

     A. Hyperkalemia

     B. Reduced blood urea nitrogen (BUN)

     C. Hypernatremia

     D. Hyperglycemia

    

    

Correct Answer: A. Hyperkalemia

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In adrenal insufficiency, the client has hyperkalemia due to reduced aldosterone secretion.

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Option B: BUN increases as the glomerular filtration rate is reduced. BUN is handled primarily by glomerular filtration with little or no renal regulation or adaptation in the course of declining renal function, they essentially reflect GFR.

Option C: Hyponatremia is caused by reduced aldosterone secretion. Aldosterone deficiency causes hyponatremia through two mechanisms: the increased levels of ADH and subsequent upregulation of aquaporin-2 water channels in the renal tubules, and the extracellular volume depletion-induced reduction in glomerular filtration rate.

Option D: Reduced cortisol secretion leads to impaired gluconeogenesis and a reduction of glycogen in the liver and muscle, causing hypoglycemia.

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