Addison Ada — Adrenal Crisis
Bronze skin, low Na⁺, high K⁺, hypotension — steroids now
Ada's adrenal glands quietly retire. She tans without sun, craves salt by the handful, and then one bout of gastroenteritis takes her blood pressure to the floor.
Ada makes too little cortisol and aldosterone. Bronzed skin, salt craving, weakness and weight loss become a crisis under stress: profound hypotension, hyponatremia, hyperkalemia and hypoglycemia. Hydrocortisone and isotonic fluids immediately.
Read Addison Ada's full story →The story arc
The setup
Autoimmune adrenal destruction — years of fatigue and salt craving dismissed as stress.
The turn
Her palm creases and gums darken; she has lost 12 pounds and feels dizzy standing up.
The crisis
A vomiting illness drops her pressure to 70/40. Sodium 124, potassium 6.2, glucose 52.
The save
IV hydrocortisone and rapid isotonic saline with dextrose; then teaching about stress dosing and an emergency injection kit.
NCLEX study section — Adrenal Crisis
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.