What sign should alert a nurse that a client with Addison's disease may be experiencing an Addisonian crisis?

In clients with Addison's disease, an Addisonian crisis, also known as acute adrenal insufficiency, is a serious and potentially life-threatening condition. One of the key signs that should alert the nurse to the possibility of an Addisonian crisis is hypotension. This occurs because individuals with Addison's disease have low levels of cortisol, which is crucial for maintaining vascular tone and blood pressure. In times of stress, such as an illness or injury, the adrenal glands may fail to produce sufficient cortisol, leading to a sudden drop in blood pressure. This hypotensive state can manifest as dizziness, fainting, and shock, making it a critical finding that requires immediate intervention.

In contrast, the other signs mentioned may not be directly indicative of an Addisonian crisis. Hyperglycemia, for instance, is typically not associated with Addison's disease since cortisol usually helps raise blood sugar levels. Instead, patients may experience hypoglycemia due to low cortisol. An increased heart rate can occur but is often a compensatory mechanism in response to hypotension rather than a definitive sign of an Addisonian crisis. Lastly, weight gain is not relevant in this context, as Addison's disease often leads to weight loss due to a decrease in appetite and other metabolic changes.

Overall, hypot