Medsurg final 4 Flashcards
Addison’s disease
an adrenocortical insufficiency
Addison’s disease is caused by
damage or dysfunction of the adrenal cortex
With Addison’s disease, the production of _____ and _____ is diminished
mineralocorticoids and glucocorticoids
With Addison’s disease, the production of mineralocorticoids and glucocorticoids is diminished, resulting in decreased
aldosterone and cortisol
a life-treating event that left untreated can lead to death
Acute adrenal insufficiency
Sepsis Trauma Stress (myocardial infarction, surgery, anesthesia, hypothermia, volume loss, hypoglycemia) Adrenal hemorrhage Steroid withdrawal
Can precipitate
Acute adrenal insufficiency
Addison’s: manifestations: Craving for
salt
Addison’s: manifestations: Weight
loss
Addison’s: manifestations: Hyper_______
hyperpigmentation
Addison’s: manifestations: Severe
hypotension (acute adrenal insufficiency)
ACTH is infused, and the cortisol response is measured 30 min and 1 hr after the injection. With primary adrenal insufficiency, plasma cortisol levels do not rise.
Adrenocorticotropic hormone (ACTH) stimulation test
Adrenocorticotropic hormone (ACTH) stimulation test: ACTH is infused, and the cortisol response is measured 30 min and 1 hr after the injection. With primary adrenal insufficiency,
plasma cortisol levels do not rise.
Addison’s tx: Monitor the client for
fluid deficits and electrolyte imbalances
Addison’s tx: if the client has fluid deficits
Administer saline infusions to restore fluid volume
Addison’s tx: Administer ____ IV bolus and a continuous infusion or intermittent IV bolus
hydrocortisone
Addison’s: electrolyte you’re worried about
hyperkalemia
Addison’s: Monitor for and treat ____glycemia
hypoglycemia
Addison’s: Administer food and/or supplemental _____.
glucose
Addison’s: _____ is used as an adrenocorticoid replacement for adrenal insufficiency and as an anti-inflammatory
Glucocorticoid
Addison’s: Glucocorticoid is used as an adrenocorticoid replacement for adrenal insufficiency and as an
anti-inflammatory
Addison’s: hydrocortisone: Increase dosage during periods of
stress or illness if necessary.
Addison’s tx: Report symptoms of Cushing’s syndrome
(round face, edema, weight gain)
Addison’s: discharge teaching: Avoid using ____ and ____
alcohol and caffeine
Addison’s: discharge teaching: monitor for ____glycemia
hypoglycemia
fever, fatigue, muscle weakness, dizziness, anorexia are symptoms of
adrenal insufficiency
To prevent acute adrenal insufficiency, instruct clients who have Addison’s disease to
increase corticosteroid doses as directed by a provider during times of stress.
Acute adrenal insufficiency (Addisonian crisis) occurs when there is an acute drop in adrenocorticoids due to sudden __________ or when induced by severe trauma, infection, or stress
discontinuation of glucocorticoid medications
Acute adrenal insufficiency (Addisonian crisis) occurs when there is an acute drop in adrenocorticoids due to sudden discontinuation of glucocorticoid medications or when induced by
severe trauma, infection, or stress
Acute adrenal insufficiency (Addisonian crisis): Administer ____ to move potassium into cell
Administer insulin to move potassium into cell. Glucose often is given with insulin.
Acute adrenal insufficiency (Addisonian crisis): Administer ____ to counteract the effects of hyperkalemia and protect the heart
calcium
Acute adrenal insufficiency (Addisonian crisis): Establish an IV line and initiate a rapid infusion of
NS
Insufficient glucocorticoid causes increased insulin sensitivity and decreased glycogen, which leads to
hypoglycemia
hypoglycemia: Instruct the client to have a __ __ ______ snack readily available
15 g carbohydrate
Decrease in ______ levels can cause an increased excretion of sodium and a decreased excretion of potassium.
aldosterone
