A client who underwent unilateral adrenalectomy is being discharged. Which instruction should the nurse include?

• A. Instruct the client to take glucocorticoid and mineralocorticoid medications as prescribed.
• B. Teach the client regarding sexual functioning and androgen replacement therapy.
• C. Explain the signs and symptoms of infection and when to call the health-care provider.
• D. Demonstrate turn, cough, and deep-breathing exercises the client should perform every two hours.

Answer: (C)

Infection prevention and early recognition of complications is the priority after a unilateral adrenalectomy. The remaining adrenal gland usually compensates, so routine lifelong hormone replacement isn’t automatically required when only one adrenal gland is removed. What’s critical for discharge is teaching the patient how to spot signs of infection and know when to contact the healthcare provider. Key indicators include fever, increasing redness, warmth, swelling, or drainage at the incision, foul odor, or any new or worsening pain. Systemic signs such as chills, sweating, or a feeling of being unusually unwell should also prompt contact with the provider. This focus helps prevent postoperative complications and ensures timely management.

Breathing exercises and other postoperative techniques are helpful, but the most essential safety message for discharge is recognizing infection signs and when to seek help. Hormone replacement considerations would be tailored to the individual based on the remaining adrenal function and surgical course, not routinely emphasized for all patients after a unilateral procedure.