Addisons Flashcards
Addison’s Disease causes disruption to which gland
Adrenal Gland
2 parts of the adrenal gland
Outside part: adrenal Cortex
Inside: Adrenal Medulla
Hormones Secreted from the adrenal cortex
- Glucocorticoids
- Mineralocorticoids
- Androgens
Glucocorticoids help manage?
Glucose
Fat metabolism
Anti-inflamoatory properties suppressing immune response
Mineralocorticoids like ALDOSTERONE help with?
Fluid and electrolyte balance
Androgens are?
Sex hormones ex: testosterone and estrogen
The Adrenal medulla secretes which hormones?
Epinephrine (adrenaline)
Norepinephrine (noreadrenaline)
(hormones responsible for flight of flight)
Addisons diseases causes______ secretion of hormones
Hypo
Hyposecretion of Hormones from Adrenal Cortex
Decreased Cortisol
Decreased Aldosterone
Decreased Androgens
Normal Function of Cortisol
Increases Glucose
Fat Metabolism
Normal Function of aldosterone
Retains Na and Water
Effects BP
Normal Function of aldosterone
Retains Na and Water
Effects BP
Cardiovascular S/S of Addisons
Hypotension
(Low aldosterone=low fluids=low blood pressure)
-pt will be tired and fatigued
Tachycardia
(body compensates from low BP)
Metabolic S/S of Addisons
weight loss
(cortisol responsible for fat metabolism)
(low cortisol=no fat metabolism)
Skin S/S of Addisons
Hyperpigmentation
(bronzing of skin)
Electrolyte Abnormalities of Addisons
Hyponatremia
(aldosterone responsible for Na and Water retention)
(decreased aldosterone=decreased Na)
Hyperkalemia
(anytime kidneys excrete Na, they hold onto K+)
Hypercalcemia
(normal glucocorticoids aid in bone absorption of Ca)
(decreased glucocorticoids=decreased absorption of Ca=Increased Ca in blood)
Hypoglycemia
normal glucocorticoids increase glucose levels
Decreased glucocorticoids=low glucose
Electrolyte Abnormalities of Addisons
Hyponatremia
(aldosterone responsible for Na and Water retention)
(decreased aldosterone=decreased Na)
Hyperkalemia
(anytime kidneys excrete Na, they hold onto K+)
Hypercalcemia
(normal glucocorticoids aid in bone absorption of Ca)
(decreased glucocorticoids=decreased absorption of Ca=Increased Ca in blood)
Hypoglycemia
normal glucocorticoids increase glucose levels
Decreased glucocorticoids=low glucose
Addisonian Crisis
Medical Emergency
Severe hypoglycemia
Severe electrolyte abnormalities
Cardiovascular collapse from lack of hormones
S/S
Severe Headache
Generalized weakness (low BP)
sudden pain in lower back or abdomen
shock (from low BP)
Dehydration (fluid volume deficient)
Management of Addisons
Admin of Replacement Hormones for LIFE
corticosteroids ex: cortisone
mineralocorticoids: fludrocortisone (helps aldosterone)
Replace Electrolytes
increase salt and water intake
Monitor Vitals: esp EKG
Monitor Electrolyes
Monitor Glucose
Addisons Assesment (Steroid)
S-sugar and sodum low
T-tired and muscle weakness
E-electrolyte imbalance (high K+, High Ca)
R-Reproductive changes
O-lOw BP
I-increased pigmentation
D-diarrhea, nausea, depression
(Muscle twitching from loss of sodium)
Drugs given for Primary adrenal insufficency
Prednisone
Prednisolone
Dexamethasone
Pt teaching when receiving glucocorticoids
- mask sign of infection by suppressing immune system
- caution in DM pts (cause hyperglycemia )
- Monitor for weight gain and edema
- Increase risk for osteoporosis
What situation increases the risk for adrenal crisis
Physiological stress
-surgey, dental work, pregnancy
We increase glucocorticoids in these situations
Priority in Addisonian Crisis
Preventing irreversible shock
Must give glucocorticoids to reverse hypotension
Expected finding in pt w/ addisonian crisis
Pain (headache, abdominal pain, back pain, extremity pain)
Cause of Primary Addisons Disease
Idiopathic atrophy of the gland
Glucocorticoids should_____be taken without food
always (cause gastric irritation and ulcers)
Take with food or an atancid
