In an Addisonian crisis, which action is most appropriate to help increase blood pressure?

In an Addisonian crisis, which action is most appropriate to help increase blood pressure?

• A. Increase sodium to raise blood pressure
• B. Increase potassium intake
• C. Administer insulin
• D. Limit fluid intake

Answer: (A)

Restoring circulating volume by replacing lost sodium is the primary way to raise blood pressure in an Addisonian crisis. Deficiency of aldosterone causes salt wasting and dehydration, so the intravascular volume is reduced. Giving sodium-containing fluids helps pull water back into the vessels and increases preload, which raises blood pressure quickly. The other options don’t address the underlying problem: increasing potassium would worsen hyperkalemia and harm cardiac rhythm; insulin would shift potassium but not fix the volume deficit and could cause hypoglycemia; limiting fluids would worsen hypotension. In crisis management, fluids with sodium (often isotonic saline) are essential to restore volume, with steroids added to address the adrenal insufficiency.

Restoring circulating volume by replacing lost sodium is the primary way to raise blood pressure in an Addisonian crisis. Deficiency of aldosterone causes salt wasting and dehydration, so the intravascular volume is reduced. Giving sodium-containing fluids helps pull water back into the vessels and increases preload, which raises blood pressure quickly. The other options don’t address the underlying problem: increasing potassium would worsen hyperkalemia and harm cardiac rhythm; insulin would shift potassium but not fix the volume deficit and could cause hypoglycemia; limiting fluids would worsen hypotension. In crisis management, fluids with sodium (often isotonic saline) are essential to restore volume, with steroids added to address the adrenal insufficiency.