👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: Florinef · mineralocorticoid · salt-retaining steroid
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Use this quick-reference guide to spot, treat, and prevent Fludrocortisone on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Use
Addison disease replacement
Orthostatic hypotension tx
📌 Mech
↑ Na+ + water retention
↑ K+ excretion → ↓K+
🧪 Monitor
BP, weight, edema
Serum K+ (hypokalemia)
🚩 Report
HTN, edema, weight gain
Hypokalemia: weak, cramps
Heart failure signs
📚 Fludrocortisone — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Fludrocortisone is a potent mineralocorticoid used in adrenal insufficiency (Addison disease) and salt-wasting congenital adrenal hyperplasia to replace aldosterone activity. It causes the kidneys to retain sodium and water and excrete potassium, helping maintain blood pressure and electrolyte balance. It is often given together with hydrocortisone, which supplies the glucocorticoid component. The main monitoring concerns are fluid overload, hypertension, and hypokalemia.
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Key points
Understand these first
Acts like aldosterone, promoting sodium and water retention and potassium excretion to support blood pressure.
Used in Addison disease and salt-wasting conditions, usually alongside a glucocorticoid like hydrocortisone.
Causes sodium and fluid retention, so weight gain, edema, and hypertension are expected effects to monitor.
Promotes potassium loss, raising the risk of hypokalemia (muscle weakness, cramps, arrhythmias).
Therapy is lifelong in chronic adrenal insufficiency and should not be stopped abruptly.
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Nursing priorities
What to do, in order
Monitor blood pressure, daily weight, and for edema due to sodium and water retention.
Monitor serum potassium and sodium and assess for signs of hypokalemia.
Assess for fluid overload such as swelling, weight gain, and shortness of breath.
Teach the patient not to stop the drug abruptly and to keep regular lab follow-up.
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Red flags — report now
Escalate immediately
Signs of hypokalemia — muscle weakness, leg cramps, irregular or rapid heartbeat; report immediately.
Significant edema, rapid weight gain, or worsening hypertension — fluid overload; report now.
Never discontinue abruptly in chronic adrenal insufficiency due to crisis risk.
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Labs & values
Numbers to know
Serum potassium 3.5-5.0 mEq/L (watch for hypokalemia)
Serum sodium 135-145 mEq/L (may rise with retention)
Monitor blood pressure for hypertension
Monitor daily weight for fluid retention
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Patient teaching
What patients must know
Weigh yourself daily and report rapid weight gain or new swelling.
Report muscle weakness, cramps, or palpitations that may signal low potassium.
Do not stop the medication suddenly and keep all lab appointments.
Report severe headaches or signs of high blood pressure.
Carry medical alert identification noting adrenal insufficiency.
❓ Fludrocortisone: NCLEX FAQs
What are the priority nursing interventions for Fludrocortisone?
Monitor blood pressure, daily weight, and for edema due to sodium and water retention. Monitor serum potassium and sodium and assess for signs of hypokalemia. Assess for fluid overload such as swelling, weight gain, and shortness of breath. Teach the patient not to stop the drug abruptly and to keep regular lab follow-up.
What are the warning signs of Fludrocortisone a nurse must report?
Signs of hypokalemia — muscle weakness, leg cramps, irregular or rapid heartbeat; report immediately. Significant edema, rapid weight gain, or worsening hypertension — fluid overload; report now. Never discontinue abruptly in chronic adrenal insufficiency due to crisis risk.
What do I need to know about Fludrocortisone for the NCLEX?
Acts like aldosterone, promoting sodium and water retention and potassium excretion to support blood pressure. Used in Addison disease and salt-wasting conditions, usually alongside a glucocorticoid like hydrocortisone. Causes sodium and fluid retention, so weight gain, edema, and hypertension are expected effects to monitor. Promotes potassium loss, raising the risk of hypokalemia (muscle weakness, cramps, arrhythmias).
What patient teaching is important for Fludrocortisone?
Weigh yourself daily and report rapid weight gain or new swelling. Report muscle weakness, cramps, or palpitations that may signal low potassium. Do not stop the medication suddenly and keep all lab appointments. Report severe headaches or signs of high blood pressure.
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Quick Tip
Acts like aldosterone, promoting sodium and water retention and potassium excretion to support blood pressure.