Adrenal Disorders Flashcards by Amanda Luque

What is a disorder where adrenal glands don’t produce enough glucorticoid hormones?

Addison’s Disease

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What is a condition from exposure to high cortisol levels for a long period of time?

Cushing’s Disease

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What secretes cortisol?

Adrenal glands

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What is cortisol?

Stress hormone

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Name this disorder: Moon face (very round face) buffalo hump (fat deposits b/t shoulder blades), thin skin, unhealed wounds, fine coating of hair on face/body, abd striae, ecchymosis, pear shaped body?

Cushing’s Disease

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Normal calcium levels?

8.5-10.2

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Cortisol levels blood, urine, saliva are taken when?

@ diff times to evaluate variations

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What may be increased in Cushing’s disease?

Sodium and glucose level

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What may be decreased in Cushing’s disease?

Potassium and calcium levels

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What diagnostic tests for Cushing’s looks for lesions of adrenal or pituitary gland?

CT/MRI/Xray

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What is a normal level of cortisol in the urine?

80-100mcg

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Name this disorder: elevated BP, bounding pulses, sodium/water retention, hypervolemia, edema, muscle atrophy, osteoporosis, elevated blood glucose, immunosuppression, increased risk for infection and emotional instability?

Cushing’s Disease

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Bilateral adrenal hyperplasia, pituitary adenoma, carcinomas of lung/GI/pancreas and adrenal adenoma or carcinoma is indicative of?

Cushing’s Disease

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Therapeutic over use of glucosteroids in asthma, autoimmune disorders, chemo, allergic responses, or chronic fibrosis is indicative of what?

Cushing’s syndrome

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What surgical procedures are commonly used for Cushing’s Disease?

Hypophysectomy and adrenalectomy

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What is hypophysectomy?

Removal of pituitary gland

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What is adrenalectomy?

Partial/complete removal of adrenal gland

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What is the halo sign that is tested after surgical procedures?

Yellow halo look around blood discharge from nose; positive for CSF

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How can a pt. know that they have CSF leak?

If salty taste leaks into mouth

What should a pt avoid if have a CSF leak?

Blowing nose, driving and bending if pain/numbness in mouth rinse w/ saline for 2wks

Which med is used in Cushing’s syndrome?

Aminogluthethimide (Cytadren)

What are some side effects of aminogluthethimide (Cytadren)?

Med failure, nausea, dizziness, skin rash, liver toxicity, jaundice, skin lesions

What are some nursing implications for aminogluthethimide (Cytadren)?

Take w/ food and monitor liver function tests

What is the drug of choice for Cushing’s?

Ketoconazole

What is another med for Cushing's?

Spironlactone (Aldactone)

What is Spironlactone (Aldactone)?

Aldosterone antagonist, blocks resorption of water and sodium

When is Spironlactone (Aldactone) used?

When adrenal hyperplasia is the cause

What are side effects of Spironlactone (Aldactone)?

Dizziness, HA, diarrhea, urinary frequency, increase potassium

What are some nursing implications for Spironlactone (Aldactone)?

Monitor vs/wt/Na/K levels

What is needed w/ Spironlactone (Aldactone)?

Potassium sparing diuretic

What are the nursing implications for fluid overload in Cushing's?

Monitor Wt, I/O, and VS assess for edema (especially in sacrum), assess breath sounds (crackles/rales/wheezes) and put on fluid restrictions

What are the nursing implications for risk for infection in Cushing's?

Monitor VS/labs, use aseptic technique, increase protein and vitamins

What are the nursing implications for knowledge deficit in Cushing's?

Education on med regimen (don't stop abruptly), diet restrictions (no alcohol/caffeine), daily wts, and s/s of infections

Autoimmune disorder, HIV/TB, Hemorrhage, infection, tumors, adrenalectomy, and sudden withdrawal of long-term, high dose glucocorticoid therapy are all causes of what?

Not enough production of glucocorticoid (Addison's)

Lack of adrenocorticotropic hormone doesn't stimulate enough what?

Cortisol

Name this disorder: diet change, increased appetite for salt, weakness/fatigue, dehydration s/s, N/V, anorexia, hyperpigmentation (90% bronze color), orthostatic hypotension and mood changes?

Addison's

What levels are high in Addison's?

BUN, Potassium and calcium

What levels are low in Addison's?

Cortisol, Glucose and sodium

ACTH Stim test, CT/MRI are what?

Diagnostic tests to evaluate adrenal/pituitary glands

What is the combo pharmacology for Addison's?

Mineralocorticoid (Florinef) and Glucocorticoid (Prednsione)

What are some adverse effects of Mineralcorticoid (Florinef) that are most important to monitor?

Wt. gain, HTN, electrolyte imblance

What are some adverse effects of Glucocorticoid (Prednisone)?

Mild edema, take as prescribed, don't stop abruptly and can lead to Cushing's

What is Addisonian Crisis?

Severe adrenal insufficiency (may be sudden or progress over several days)

S/S of Addisonian Crisis?

Severe hypotension, circulatory collapse, shock, coma

What are the 5 S's to treat Addisonian Crisis?

``` Salt replacement (.9NS) Sugar replacement (D5 electrolyte replacement) Steroid Replacement (IV) Support of physiological functioning (GI/resp/metabolism) Search for and treat an underlying cause (ex. infection) ```

What are important nursing interventions for fluid volume deficit in Addisons's disease?

Physical s/s (dry furrows on tongue), VS, monitor labs/wt, increase fluid intake, and sit/stand slowly

What are important nursing interventions for risk for injury in Addison's disease?

Assess mental status, assess for hypoglycemia, assess VS (hypotension/tachycardia) and assess for dehydration