Adrenal Disorders (Addisons, Cushings, Pheochromocytoma)

Question 1

Which hormones are released by the adrenal medulla?

Answer 1

Catecholamines (epinephrine and norepinephrine)

Question 2

Which hormones are released by the adrenal cortex?

Answer 2

Glucocorticoids (cortisol), mineralcorticoids (aldosterone), and sex steroids (testerone)

Question 3

Cushing’s Syndrome is usually caused by

Answer 3

Longterm use of oral systemic steroids

Question 4

A patient with Cushing’s Syndrome has ______ cortisol levels

Answer 4

Increased

Question 5

A patient with Cushing’s Syndrome has ______ aldosterone levels

Answer 5

Increased

Question 6

A patient with Cushing’s Syndrome has ______ sodium levels

Answer 6

Increased

Question 7

A patient with Cushing’s Syndrome has ______ potassium levels

Answer 7

Decreased

Question 8

Diet recommendations for patient with Cushing’s Syndrome

Answer 8

Increased protein and potassium; decreased calories and sodium

Question 9

A patient with Addison’s Disease has _______ potassium levels

Answer 9

Increased

Question 10

A patient with Addison’s Disease has _______ sodium levels

Answer 10

Decreased

Question 11

A patient with Addison’s Disease has _______ blood pressure

Answer 11

Low

Question 12

A patient with Addison’s Disease has _______ cortisol levels

Answer 12

Decreased

Question 13

A patient with Addison’s Disease has _______ aldosterone levels

Answer 13

Decreased

Question 14

ACTH is released by the _______

Answer 14

anterior pituitary

Question 15

ACTH targets the __________

Answer 15

adrenal cortex

Question 16

Treatment for Addison’s Disease

Answer 16

Hormone replacement therapy:
Daily hydrocortisone; 2/3 on awakening; 1/3 late afternoon
Daily fludrocortisone (Florinef) in am
Salt additives for heat/humidity
(Increased doses when stressed)

Question 17

3 x 3 rule for hormone replacement therapy dosing

Answer 17

3 times the normal dose for 3 days when stressed

Question 18

What is an Addisonian Crisis?

Answer 18

ACUTE adrenal insufficiency

Question 19

Treatment for Addisonian Crisis

Answer 19

IV hydrocortisone, saline, and dextrose

Question 20

An Addison’s Disease emergency kit contains . . .

Answer 20

hydrocortisone 100 mg IM injection, syringes, and instructions

Question 21

Nursing care during Addisonian Crisis

Answer 21

Frequent vital signs and stress free environment

Question 22

Pheochromocytoma is a tumor on the _______

Answer 22

adrenal medulla

Question 23

How is the pheochromocytoma diagnosed?

Answer 23

Elevated (24-hr) urine and plasma catecholamines

Question 24

Symptoms of pheochromocytoma

Answer 24

Intractable high BP, palpitations, headache, and episodic sweating

Question 25

Treatment for phreochromocytoma

Answer 25

Remove the tumor