Steroid-dependent states and adrenal insufficiency. Fluid and electrolyte disturbances.

Patients on steroid hormone therapy for chronic adrenal insufficiency experience stable fluid and electrolyte balance. The patient with acute adrenal insufficiency, however, experiences a fluid and electrolyte balance crisis that develops over a few short hours. Nurses in all health care settings need to be alert for patients at risk for crisis and the characteristic symptoms of acute adrenal insufficiency. Nursing interventions aimed at correcting fluid and electrolyte imbalance and providing patient education for prevention of further crisis is critical.