Addisons Disease

Question 1

Addison’s disease

Answer 1

Hyposecretion of adrenal cortex hormones; autoimmune destruction is a common cause. Therapeutic use of corticosteroids is the most common cause of adrenocortical insufficiency; symptoms may occur from the sudden stopping. Requires lifelong replacement of glucocorticoids and possibly mineralocorticoids.

Question 2

Addison’s disease Assessment & interventions

Answer 2

Monitor for:
- obesity
- reduced cardiac output
- infertility
- fatigue
- low BP
- tumors of the pituitary
- Provide hormone therapy as ordered
- provide emotional support

Question 3

Addison’s Disease

Answer 3

• Addison’s disease is a rare but serious adrenal gland disorder in which the body can’t produce enough of two critical hormones, cortisol and aldosterone.
• Patients with Addison’s will need hormone replacement therapy for life

Question 4

Addison’s Disease 2

Answer 4

• HypOsecreation of adrenal cortex hormones
  — Mineralocorticoids
  — Glucocorticoids
  — Andgrogens
• Decreased secretion of cortisol & aldosterone

Question 5

Addison’s Disease 3

Answer 5

• Fight/Flight mechanism is not functioning normally-
• Body does not adapt well to stress
• Because adrenal gland is under secreting
• With any type of stress encountered, body will decompensate very quickly!
  — SUDDEN drop in BP & glucose levels. Pt quickly goes into shock

Question 6

Addison’s Disease S/S

Answer 6

• Decreased Blood Glucose levels
• Decreased BP- can lead to shock
• Hyperpigmented (tan bronze color), thin, muscle weakness
• Decrease in sodium, dehydration
• Salt cravings!
• Increase in potassium (acidosis), arrhythmias

Question 7

Addison’s Disease- Nursing care

Answer 7

• Administration of glucocorticoids
• End in “sone”
• Add-a
• prednisone
• cortisone
• betamethasone
• dexamethasone
• bethclomethasone

Question 8

Addison’s Disease- Education

Answer 8

• Wear medical alert bracelet- BP could quickly drop
• Carry simple carbs with them at all times since blood glucose levels could quickly fall
• Life long administration of hormone replacement therapy
• Avoid factors that precipitate addisonian crisis (physical & psychological stress, inadequate steroid replacement)

Question 9

Addisonian crisis

Answer 9

• a life-threatening disorder caused by acute adrenal insufficiency.
• Precipitated by stress, infection, trauma, surgery or abrupt withdrawal of exogenous corticosteroid use.
• Can cause hyponatremia, hyperkalemia, hypoglycemia, and shock.

Question 10

Addisonian crisis Assessment & interventions

Answer 10

• Monitor for severe headache, severe abdominal, leg and lower back pain, generalized weakness, irritability and confusion, severe hypotension and shock.
• Administer glucocorticoids IV, IV fluids to replace fluids and restore electrolytes. Progress to oral corticosteroids after crisis is resolved.
• Continued monitoring of vital signs, neuro status, intake and output, lab values (Na, K, blood glucose), prevent infection and provide a quiet environment.