Addisons Disease Flashcards
What cause Addisons Disease?
Autoimmune Disorders like TB, hemorrhage infections, cancers, medications (ketoconazole or mitotane Removal of the pituitary gland Sudden cessation of glucocorticoids Hypothalamus issues
Manifestations of Addison’s disease?
Anorexia Weight loss Hypovolemia Hyper pigmentation Emotional lability Decrease in body hair Craving salt
Lab values for Addisons Disease
Hyponatremia Hyperkalemia Hypovolemia Hypoglycemia Hypercalcemia Elevated BUN Elevated ACTH Elevated eosinophils
Diagnostic tests for Addisons
ACTH stimulation test Cortisol levels CT MRI- find tumors X-RAY arteriography
Treatment for Addisons
Hormone Replacement therapy Hydrocortisone Fludurocortisone Acetaminophen (Pain) IV insulin (hyperkalemia) IV dexamethasone
5 S’s of Addison Management
Salt Replacement Sugar Replacement Steroid Replacement Support Physiologic Function Search and Treat cause
Addisons Disease is the insufficiency or the over production of cortisol?
Insufficiency
Hydrocortisone
Synthetic adrenocorticsl steriod
Immunosuppressive qualities
Alters metabolism
Fludrocortisone
Synethetic adrenal corticosteroids
Raises extra cellular volume and raises BP
Lowers potassium levels
Nursing care for Addison’s disease
Obtain H&P, assess for signs of infections, monitor for orthostatic hypotension, monitor for dehydration, monitor electrolytes and glucose levels, monitor bowel sounds and bowel patterns, assess CV and pulmonary function, monitor LOC, monitor for GI bleeds, monitor for signs of Cushing’s, assist with ambulation and ADL’s
Patient education for Addison’s disease
Report any weight gain
Report any heartburn/indigestion (do not take otc meds for heartburn)
Report insomnia or mood swings
Avoid alcohol and aspirin
Report any slow to heal wounds
Take Vitamin D and calcium to reduce the risk of osteoporosis
Patient teaching for corticosteroids
Might gain 5 lbs Hypotension Monitor electrolytes Take with food Peripheral edema Wean off meds
Addisionian crisis
Circlulatory collapse
Shock
coma
Priority problems with Addisons
Fluid volume deficit
Risk for injury
Knowledge deficit
Body image
