Treatment for suspected adrenal crisis should include which of the following?

• A. IV glucose, saline, and hydrocortisone
• B. Oral glucose and diuretics
• C. Hypertonic saline alone
• D. IV glucose, saline, and hydrocortisone

Answer: (D)

Adrenal crisis is an emergency where the body lacks enough cortisol, causing shock, electrolyte disturbances, and sometimes low blood sugar. The treatment that best covers all of these problems is to replace the missing hormone, support circulation with fluids, and supply glucose as needed. Hydrocortisone IV provides both glucocorticoid and mineralocorticoid effects, helping reverse hypotension and electrolyte issues. Early infusion of isotonic saline restores intravascular volume and improves perfusion. IV glucose is important to correct or prevent hypoglycemia that can come with cortisol deficiency. Putting these elements together—glucocorticoid replacement, aggressive fluid resuscitation, and glucose support—addresses the key derangements in adrenal crisis, making it the most appropriate choice. The other options miss one or more essential components, such as omitting steroids, fluids, or using inappropriate agents for an acute crisis.