Before discharge, what should a client with Addison's disease be instructed to do when exposed to periods of stress?

• A. Administer hydrocortisone I.M.
• B. Drink 8 oz of fluids
• C. Perform capillary blood glucose monitoring four times daily
• D. Continue to take his usual dose of hydrocortisone

Answer: (A)

Periods of stress increase the body's need for cortisol, and in Addison's disease the body cannot meet that demand. If a person is discharged and faces stress, giving hydrocortisone intramuscularly provides rapid glucocorticoid replacement when oral intake may be unreliable or when a quick dose is needed to prevent an adrenal crisis. This immediate IM dose helps maintain blood pressure, fluid balance, and metabolic stability while you contact the healthcare provider for further dosing instructions and to resume or adjust oral hydrocortisone as soon as possible. Fluids are important, but they don’t substitute for the missing cortisol response, and continuing the usual dose during a stress episode would not adequately meet the body's increased needs.