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NURS 2514 > Week 11 - Addison's Disease > Flashcards

Week 11 - Addison's Disease Flashcards

1
Q

what is addisons disease

A
  • primary adrenal insufficiency
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2
Q

what causes addisons disease

A
  • destruction of the adrenal cortex resulting in decreased cortisol, aldo, and adrenal androgens
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3
Q

what are some specific causes of addisons (4)

A
  • autoimmune
  • tubercolosis
  • AIDS related cytomegalovirus infection
  • adrenal tumour
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4
Q

who does addisons disease most commonly occur oin

A
  • caucasian women
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5
Q

what does reduced inhibition on the hypothalamus and pituitary gland in addisons cause during addisons

A
  • elevated ACTH = hyperpigmention
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6
Q

what effects does reduced aldo have on the body during addisons (4)

A
  • hyponatremia
  • hyperkalemia
  • hypotension & dehydration
  • metabolic acidosis
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7
Q

what effect does reduced cortisol lvls have on the body during addisons (3)

A
  • decreased BG between meals
  • weakness & fatigue
  • decreased tolerance to stress
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8
Q

what CNS effects does addisons have (3)

A
  • irritability
  • depression
  • fatigue
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9
Q

what GI effect does addisons have (3)

A
  • NV

- diarrhea

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10
Q

what effect does addisons have on weight & appetite (2)

A
  • weight loss

- anorexia

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11
Q

what is a life-threatening complication associated w addisons disease

A
  • addisonian crisis/adrenal crisis
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12
Q

what triggers adrenal crisis (7)

A
  • stress
  • sudden corticosteroid withdrawal
  • adrenal surgery
  • sudden pituitary gland destruction
  • trauma
  • surgery
  • dehydration
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13
Q

what is adrenal crisis

A
  • acute adrenal insufficiency
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14
Q

what is especially severe during adrenal crisis

A
  • corticosteroid deficiencies
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15
Q

what is adrenal crisis characterized by (12)

A
  • hypotension & signs of shock
  • tachycardia
  • metabolic acidosis
  • hypoglycemia
  • NV, diarrhea
  • dehydration
  • loss of conciousness & coma
  • hyponatremia
  • hyperkalemia
  • weakness, confusion
  • fever
  • abdom pain

basically every sign of addisons but just kicked up a notch

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16
Q

how is adrenal crisis treated

A
  • shock management

- aggressive hydrocortisone replacement

17
Q

what is secondary adrenal insufficiency

A
  • adrenal insufficiency most commonly caused by rapid withdrawal of glucocorticoids for inflammatory diseases
18
Q

explain how rapid withdrawal of glucocorticoids can lead to adrenal insufficiency

A
  • ACTH has a “growth” effect on the adrenal cortex
  • admin of exogenous cortisone inhibits normal ACTH release (thru the negative feedback mech) = adrenal atrophy
  • when the drug is removed, the adrenal gland is unable to produce adequate hormones
19
Q

what helps prevent secondary adrenal insufficiency

A
  • weaning off exogenous cortisone
20
Q

how is addisons diagnosed (6)

A
  • serum cortisol
  • ACTH stimulation test
  • other abnormal lab results
  • ECG
  • CT or MRI
21
Q

what findings would you expect for serum cortisol in a pt with addisons

A
  • low
22
Q

what is ACTH stimulation test

A
  • test that measures how well the adrenal glands respond to ACTH
23
Q

if the result of an ACTH stimulation test is low cortisol persisting, where would the problem be located

A
  • in the adrenal gland
24
Q

if the result of an ACTH stimulation test is a rise in cortisol, where would the problem be located

A
  • in the pituitary gland (since that is what secretes ACTH)
25
Q

what are other abnormal lab results you may see in a pt with addisons (7)

A
  • hyperkalemia
  • hyponatremia
  • hypochloremia
  • hypoglycemia
  • anemia
  • increased BUN
  • low cortisol & aldo
26
Q

why is an EKG used as a diagnostic for addison’s

A
  • addisons may cause arrythmias d/t hyperkalemia
27
Q

why is a MRI & CT used for addisons

A
  • to identify any tumours
28
Q

what is the treatment for addisons (2)

A
  • hydrocortisone replacement therapy

- increased salt in diet

29
Q

what is one thing to note with the dosing of hydrocortisone

A
  • dose needs to be increased w stress
30
Q

provide two examples of how dosing of hydrocortisone must be altered due to stress

A
  • minor stress (exam, dental procedure) = doubled

- major stress (ex. divorce) = tripled

31
Q

what is the nurses role for a pt with addisons

A
  • frequent assessments

- meds & med educations

32
Q

what do you do if youre in doubt about a pt missing a dose

A
  • increase dose just to be safe

NURS 2514 (75 decks)

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