A client with a history of bilateral adrenalectomy presents with a weak, irregular pulse and hypotension. Which assessment finding warrants immediate intervention?

• A. Ventricular arrhythmias
• B. Sinus tachycardia
• C. Atrial fibrillation
• D. Sinus bradycardia

Answer: (A)

Adrenal crisis from loss of adrenal hormones leads to electrolyte disturbances, especially hyperkalemia, which profoundly affects heart conduction. High potassium levels shorten repolarization and can cause dangerous ventricular rhythms that quickly compromise circulation. In a patient with a weak, irregular pulse and hypotension, the emergence of a ventricular arrhythmia signals a life-threatening instability that requires immediate intervention. Other rhythms listed can occur in various conditions, but they do not carry the same abrupt risk of sudden deterioration as a ventricular rhythm in this adrenal-crisis context.