A nurse is caring for a client with Addison's disease and monitors for signs of Addisonian crisis. Which manifestation would be most associated with this crisis?

• A. Agitation
• B. Diaphoresis
• C. Restlessness
• D. Severe abdominal pain

Answer: (D)

Addisonian crisis is an acute, life-threatening drop in cortisol and aldosterone due to primary adrenal insufficiency. Because the body cannot mount an adequate stress response, there is profound volume depletion, electrolyte disturbances, hypoglycemia, and reduced tissue perfusion. The GI tract is particularly affected, so severe abdominal pain often accompanies nausea, vomiting, and diarrhea, along with signs of dehydration and hypotension. These GI symptoms—especially severe abdominal pain—are more characteristic of a crisis than the other options, which reflect general distress or a stress response rather than a specific crisis pattern. Agitation, restlessness, and diaphoresis can occur in many emergencies, but severe abdominal pain with systemic signs points more directly to Addisonian crisis and requires prompt intervention with fluids, electrolytes, and corticosteroids.