A client with Addisonian crisis is given IV infusion. Which medication would be administered by IV infusion?

• A. Insulin
• B. Hydrocortisone
• C. Potassium
• D. Hypotonic saline

Answer: (B)

In an Addisonian crisis, the immediate need is glucocorticoid replacement and hemodynamic stabilization. Administering hydrocortisone IV provides the cortisol replacement the adrenal glands can’t supply during a crisis and also offers some mineralocorticoid effect to help with blood pressure and electrolyte balance. This is essential to restore vascular tone and prevent shock.

Insulin isn’t indicated as the primary treatment in this scenario unless there’s hyperglycemia to manage, which isn’t the central issue in an acute adrenal crisis. Potassium would typically be controlled, not replaced, because hyperkalemia is common with adrenal insufficiency; giving potassium would worsen the electrolyte imbalance. Hypotonic saline isn’t the primary medication; initial fluid therapy is usually isotonic saline to support circulation and correct volume depletion.

So, IV hydrocortisone is the medication most directly addressing the crisis needs.