A patient with Addison disease is experiencing problems with fluid balance. What actions should the nurse take to help this patient?

Question

Select all that apply.

1. teach to sit and stand slowly
2. monitor cardiac monitor rhythm
3. turn and reposition every 2 hours while awake
4. weigh the patient daily at the same time and in the same clothing
5. encourage oral fluid intake of 3000 mL/day and increased salt intake

Answer 1

Correct Answer: 1, 2, 4, 5
The nurse should teach the patient to sit and stand slowly, and provide assistance as necessary. Extracellular fluid volume deficit causes orthostatic hypotension, dizziness, and possible loss of consciousness. These manifestations increase the risk of injury from falls. A drop in aldosterone levels can reduce renal excretion of potassium, leading to increased blood levels and the potential for cardiac dysrhythmias. The nurse should weigh the patient daily at the same time and in the same clothing because dehydration is manifested by weight loss. The nurse should encourage an oral fluid intake of 3,000 mL/day and an increased salt intake. Cortisol deficiency increases fluid loss, leading to extracellular fluid volume depletion. Oral fluid replacement is necessary to balance this loss. An increase in dietary sodium can reduce the hyponatremia characteristic of adrenal insufficiency. Turning and repositioning would be beneficial to maintain skin integrity, not to address a fluid imbalance.