What should the nurse prioritize when caring for a client after an adrenalectomy?

After an adrenalectomy, the client may experience significant physiological changes due to the removal of the adrenal glands, which play a vital role in hormone production, including cortisol and aldosterone. Prioritizing the monitoring for signs of shock is crucial because the client is at risk for acute adrenal insufficiency, especially if there is inadequate hormone replacement or if the surgery was performed due to an adrenal tumor that may have been producing excess hormones.

Shock can manifest through symptoms such as hypotension, tachycardia, and altered mental status, making vigilance in monitoring these indicators essential in the immediate postoperative period. The potential for acute adrenal crisis makes this a priority, as timely intervention can be life-saving.

Additionally, while observing urine output, administering pain medication, and checking serum electrolyte levels are important aspects of post-operative care, they do not address the immediate risk of shock associated with the loss of adrenal function. The endocrine system's rapid response is critical when the body suddenly lacks the hormones that help regulate blood pressure, fluid balance, and stress response. Therefore, monitoring for signs of shock takes precedence in ensuring the client remains hemodynamically stable following surgery.