Adrenal disorders (405) Flashcards

1
Q

what are the two adrenal disorders

A

1) Cushing’s disease/syndrome
2) Addison’s disease

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2
Q

what is the most common cause of Cushing’s syndrome

A

oral systemic steroids

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3
Q

Cushing’s syndrome CM

A

-glucose intol & hypergly
-HTN, capillary friability, bruising, fluid retention
-muscle wasting & weakness, thinning skin
-osteoporosis
-moon face, buffalo hump, skinny extremities
-impaired wound healing & immune response
-risk for infection
-mood swings & insomnia

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4
Q

Cushing’s clinical presentation (upper body)

A

thin body hair, upper body obesity, moon face, buffalo hump, hirsutism, thinning arms & legs

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5
Q

Cushing’s clinical presentaiton (lower body)

A

skin, fragile & thin, bruising, poor healing, purplish stretch marks

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6
Q

pts w/ Cushing’s are at risk for what electrolyte imbalance

A

hypokalemia
inc alderstone, inc Na+, dec K+

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7
Q

what type of BP are people w/ Cushing’s at risk for

A

hypertension secondary to salt retaining activity of cortisol & increased blood volume

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8
Q

Cushing’s definition

A

too much cortisol

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9
Q

Cushing’s primary goal

A

normalize hormone secretion

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10
Q

Cushing’s treatment

A

treat underlying cause
-adrenalectomy
-removal of tumor
-drug therapy
-reduce steroid use

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11
Q

Cushing’s related nursing care

A

-I&Os + daily wts
-glucose metabolism
-monitor VS
-prevent & monitor infection
-offer emotional support

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12
Q

Cushing’s diet teaching

A

-increased protein & potassium
-decreased kcals & Na

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13
Q

Addison’s disease is caused by

A

sudden insufficiency of serum corticosteroids

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14
Q

what hormones are involved in Addison’s disease

A

decreased secretion of
-cortisol (primary stress hormone)
-aldosterone (steroid hormone)
-androgens (male hormones)

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15
Q

Addison’s disease CM: early

A

-anorexia
-weakness, malaise, apathy
-hyperK
-skin hyperpigmentation

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16
Q

Addison’s disease CM

A

hypoaldosteronism
-hypotension
-dec CO
-salt craving / low serum Na
-dehy
hypocortisolism
-hypoglym
-weakness & fatigue
-unsuppressed ACTH production
-hyperpigmentation

17
Q

Addison’s disease primary nursing problems

A

-FVD
-malnut
-activity intol
-addisonian crisis

18
Q

Addison’s disease treatment

A

-daily hydrocortisone
-daily fludrocortisone (exogenous aldosterone)
-salt additives for heat & humidity
increase dosages in times of stress

19
Q

cortisol replacement therapy for Addison’s disease teaching points

A

-closely follow prescription
-never abruptly stop
-lifelong
-3X3 rule when stressed
-always have emergency supply
-wear med alert bracelet

20
Q

3X3 rule

A

3 times the normal dose for 3 days when stressed

21
Q

sx of Addisonian crisis

A

-sudden penetrating pain in the lower back, abdomen or legs
-severe vomiting & diarrhea
-dehy
-low blood pressure
-loss of consciousness

22
Q

Addisonian crisis treatment

A

IV: hydrocortisone, saline & dextrose
PO: once tolerated

23
Q

Addison’s disease emergency kit

A

-hydrocortisone 100mg IM
-syringes
-instructions

24
Q

Addison’s disease nursing care

A

-frequent vital signs
-stress free environment
-low lights & volume

25
Q

pheochromocytoma is found where

A

on the adrenal medulla

26
Q

pheochromocytoma triad of symptoms

A

based on high BP
-palpitations
-headache
-episodic sweating

27
Q

how to treat pheochromocytoma

A

remove the tumor

28
Q

function of cortisol

A

-inc glucose availability
-maintain vascular system
-protein breakdown
-fat breakdown
-suppression of immune & inflammatory responses
-CNS excitability