A client with adrenal hyperfunction screams at her husband, bursts into tears, and throws a water pitcher against the wall, saying, 'I feel like I am going crazy.' How should the nurse respond?

A client with adrenal hyperfunction screams at her husband, bursts into tears, and throws a water pitcher against the wall, saying, 'I feel like I am going crazy.' How should the nurse respond?

• A. I will ask your doctor to order a psychiatric consult for you.
• B. You feel this way because of your hormone levels.
• C. Can I bring you information about support groups?
• D. I will close the door to your room and restrict visitors.

Answer: (B)

Emotional upheaval in adrenal hyperfunction is often tied to the hormonal changes affecting the brain, especially the mood- and impulse-related effects of cortisol. A therapeutic response validates what the patient is experiencing and offers a clear, biologic explanation rather than labeling her as mentally ill. Saying, “You feel this way because of your hormone levels” does three important things: it acknowledges her distress, provides an accurate reason rooted in the medical condition, and helps her feel understood and less alone with these symptoms. This approach also keeps the focus on a treatable physiological cause and sets the stage for discussing treatment, safety, and how hormone levels may influence mood. While there is a role for providing support resources or addressing safety as needed, attributing the symptoms to hormone levels is the most appropriate and helpful first response.

Emotional upheaval in adrenal hyperfunction is often tied to the hormonal changes affecting the brain, especially the mood- and impulse-related effects of cortisol. A therapeutic response validates what the patient is experiencing and offers a clear, biologic explanation rather than labeling her as mentally ill. Saying, “You feel this way because of your hormone levels” does three important things: it acknowledges her distress, provides an accurate reason rooted in the medical condition, and helps her feel understood and less alone with these symptoms. This approach also keeps the focus on a treatable physiological cause and sets the stage for discussing treatment, safety, and how hormone levels may influence mood. While there is a role for providing support resources or addressing safety as needed, attributing the symptoms to hormone levels is the most appropriate and helpful first response.