Which corticosteroid therapy teaching should be prioritized for a client with Addison's disease?

Which corticosteroid therapy teaching should be prioritized for a client with Addison's disease?

• A. Plan a high-carbohydrate diet.
• B. Increase daily sodium.
• C. Decrease daily calcium.
• D. Do not stop taking the medication abruptly.

Answer: (D)

In Addison's disease, the body relies on replacement corticosteroid therapy because natural cortisol and mineralocorticoid activity are deficient. The most critical safety message is to never stop the medication abruptly. Stopping suddenly can trigger an acute adrenal crisis because the hypothalamic-pituitary-adrenal axis is suppressed by ongoing therapy, and the body cannot mount an adequate cortisol response to stress. This crisis can cause severe low blood pressure, shock, dehydration, hypoglycemia, and can be life-threatening. Therefore, the priority teaching is to maintain consistent dosing and to follow guidance for tapering only under medical supervision, as well as to use stress dosing during illness or surgical stress and to seek emergency care if crisis signs appear. Dietary and mineral considerations, such as salt needs due to aldosterone deficiency, are important parts of long-term management but do not carry the same immediate safety risk as abrupt discontinuation. Calcium is not a primary concern in this context.

In Addison's disease, the body relies on replacement corticosteroid therapy because natural cortisol and mineralocorticoid activity are deficient. The most critical safety message is to never stop the medication abruptly. Stopping suddenly can trigger an acute adrenal crisis because the hypothalamic-pituitary-adrenal axis is suppressed by ongoing therapy, and the body cannot mount an adequate cortisol response to stress. This crisis can cause severe low blood pressure, shock, dehydration, hypoglycemia, and can be life-threatening.

Therefore, the priority teaching is to maintain consistent dosing and to follow guidance for tapering only under medical supervision, as well as to use stress dosing during illness or surgical stress and to seek emergency care if crisis signs appear.

Dietary and mineral considerations, such as salt needs due to aldosterone deficiency, are important parts of long-term management but do not carry the same immediate safety risk as abrupt discontinuation. Calcium is not a primary concern in this context.