Which clinical manifestation should the nurse expect to note when assessing a client with Addison's disease?

• A. Edema
• B. Obesity
• C. Hirsutism
• D. Hypotension

Answer: (D)

In Addison's disease, the adrenal glands fail to produce enough aldosterone and cortisol. The lack of aldosterone causes salt wasting and water loss in the kidneys, which reduces extracellular fluid volume and blood pressure. So the nurse should expect hypotension as a prominent clinical manifestation, often with signs of dehydration and possibly tachycardia.

Edema or obesity wouldn’t fit the typical pattern of Addison’s because this condition involves fluid and sodium loss rather than retention. Hirsutism isn’t a characteristic feature of adrenal failure; it’s more related to androgen excess or other conditions. Hyperpigmentation due to elevated ACTH can occur, which helps explain some skin changes, but the most reliable bedside clue listed here is low blood pressure.