The nurse is planning care for a client with AIDS who has developed an infection in the adrenal gland. Which problem would have the highest priority?

The nurse is planning care for a client with AIDS who has developed an infection in the adrenal gland. Which problem would have the highest priority?

• A. Altered body image
• B. Activity intolerance
• C. Impaired coping
• D. Fluid volume deficit

Answer: (D)

Fluid volume deficit is the most urgent concern here because adrenal infection can precipitate adrenal insufficiency, causing poor cortisol and aldosterone production. This leads to salt wasting, dehydration, hypotension, and decreased tissue perfusion, which can progress to shock if not promptly addressed. In nursing priorities, maintaining circulating volume takes precedence because without adequate perfusion, other problems—even important ones like coping or body image—cannot be effectively managed. Look for signs of dehydration and shock (dry mucous membranes, poor skin turgor, weight loss, decreased urine output, tachycardia, hypotension) and respond with close monitoring of intake and output and vital signs, plus timely administration of IV fluids and any endocrine replacement therapy as ordered. Treating the infection and supporting the adrenal axis are essential to stabilizing the patient; once circulation is stabilized, attention can turn to coping, activity tolerance, and body image.

Fluid volume deficit is the most urgent concern here because adrenal infection can precipitate adrenal insufficiency, causing poor cortisol and aldosterone production. This leads to salt wasting, dehydration, hypotension, and decreased tissue perfusion, which can progress to shock if not promptly addressed. In nursing priorities, maintaining circulating volume takes precedence because without adequate perfusion, other problems—even important ones like coping or body image—cannot be effectively managed. Look for signs of dehydration and shock (dry mucous membranes, poor skin turgor, weight loss, decreased urine output, tachycardia, hypotension) and respond with close monitoring of intake and output and vital signs, plus timely administration of IV fluids and any endocrine replacement therapy as ordered. Treating the infection and supporting the adrenal axis are essential to stabilizing the patient; once circulation is stabilized, attention can turn to coping, activity tolerance, and body image.