Adrenal Disorders Flashcards
What is a disorder where adrenal glands don’t produce enough glucorticoid hormones?
Addison’s Disease
What is a condition from exposure to high cortisol levels for a long period of time?
Cushing’s Disease
What secretes cortisol?
Adrenal glands
What is cortisol?
Stress hormone
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
Normal calcium levels?
8.5-10.2
Cortisol levels blood, urine, saliva are taken when?
@ diff times to evaluate variations
What may be increased in Cushing’s disease?
Sodium and glucose level
What may be decreased in Cushing’s disease?
Potassium and calcium levels
What diagnostic tests for Cushing’s looks for lesions of adrenal or pituitary gland?
CT/MRI/Xray
What is a normal level of cortisol in the urine?
80-100mcg
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
Bilateral adrenal hyperplasia, pituitary adenoma, carcinomas of lung/GI/pancreas and adrenal adenoma or carcinoma is indicative of?
Cushing’s Disease
Therapeutic over use of glucosteroids in asthma, autoimmune disorders, chemo, allergic responses, or chronic fibrosis is indicative of what?
Cushing’s syndrome
What surgical procedures are commonly used for Cushing’s Disease?
Hypophysectomy and adrenalectomy
What is hypophysectomy?
Removal of pituitary gland
What is adrenalectomy?
Partial/complete removal of adrenal gland
What is the halo sign that is tested after surgical procedures?
Yellow halo look around blood discharge from nose; positive for CSF
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
