Western Governors University (WGU) D446 Adult Health II Practice Exam

Addisonian crisis requires rapid replacement of both circulating volume and cortisol. The immediate priority is to stabilize the patient’s hemodynamics and metabolic stress because cortisol deficiency contributes to hypotension, shock, and electrolyte disturbances. Initiating IV isotonic fluids, usually normal saline, quickly expands intravascular volume, corrects dehydration, and helps normalize blood pressure and sodium balance. At the same time, providing steroids—typically hydrocortisone given IV—replaces the missing cortisol and also offers some mineralocorticoid activity, which supports vascular responsiveness and sodium retention during this acute crisis. This combination addresses the underlying deficiency and the life-threatening instability. Desmopressin is not indicated for adrenal crisis; it treats ADH-related disorders, not cortisol deficiency. Relying on electrolyte repletion alone won’t resolve the crisis because the primary issue is cortisol deficiency. Oral hydration is insufficient in this acute setting where rapid stabilization is needed. After stabilization, ongoing management includes careful electrolyte monitoring and transitioning to longer-term adrenal replacement as appropriate.