A client with a history of adrenocortical insufficiency is experiencing nausea, vomiting, hypotension, and seizures. The nurse suspects the client discontinued which medication?
1. Hydrocortisone
2. Fluticasone propionate (Flonase)
3. Cosyntropin (Cortrosyn)
4. Methadone
Correct Answer: 1
Rationale 1: If a client with a history of adrenocortical insufficiency stops taking prescribed medications, the atrophied adrenal glands will not be able to secrete sufficient corticosteroids, and symptoms of adrenal crisis will appear.
Rationale 2: Fluticasone propionate (Flonase) does not cause adrenal crisis if withdrawn.
Rationale 3: Cosyntropin (Cortrosyn) does not cause adrenal crisis if withdrawn.
Rationale 4: Methadone does not cause adrenal crisis if withdrawn.
Global Rationale: If a client with a history of adrenocortical insufficiency stops taking prescribed medications, the atrophied adrenal glands will not be able to secrete sufficient corticosteroids, and symptoms of adrenal crisis will appear. Fluticasone propionate (Flonase), cosyntropin (Cortrosyn) and methadone do not cause adrenal crisis if withdrawn.
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