For which reason would telemetry monitoring be indicated for a patient with acute adrenal insufficiency?

For which reason would telemetry monitoring be indicated for a patient with acute adrenal insufficiency?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypocalcemia
• D. Hyperglycemia

Answer: (A)

In acute adrenal insufficiency the deficit of aldosterone leads to reduced potassium excretion by the kidneys, causing hyperkalemia. This rise in potassium can rapidly disrupt cardiac conduction and produce dangerous arrhythmias, so continuous telemetry monitoring is indicated to detect and respond to those rhythm changes promptly. Early ECG signs of hyperkalemia include tall, peaked T waves; as levels rise, the PR interval lengthens and the QRS widens, potentially progressing to a sine-wave pattern and life-threatening rhythms. While hyponatremia and other electrolyte abnormalities can occur, they do not carry the same immediate risk to cardiac rhythm as hyperkalemia in this context, and hyperglycemia is not typically the presenting issue in acute adrenal crisis.

In acute adrenal insufficiency the deficit of aldosterone leads to reduced potassium excretion by the kidneys, causing hyperkalemia. This rise in potassium can rapidly disrupt cardiac conduction and produce dangerous arrhythmias, so continuous telemetry monitoring is indicated to detect and respond to those rhythm changes promptly. Early ECG signs of hyperkalemia include tall, peaked T waves; as levels rise, the PR interval lengthens and the QRS widens, potentially progressing to a sine-wave pattern and life-threatening rhythms. While hyponatremia and other electrolyte abnormalities can occur, they do not carry the same immediate risk to cardiac rhythm as hyperkalemia in this context, and hyperglycemia is not typically the presenting issue in acute adrenal crisis.