Week 13 - Addison's Disease

Question 1

What is the etiology of Addison’s? (4)

Answer 1

• lack of endogenous corticosteroids
• Most often autoimmune is nature, greatest prevalence in Caucasian women
  Primary Addisons’s:
• All mineralocorticoids, corticosteroids and androgens are reduced

Question 2

What are the primary clinical manifestations of Addison’s? (4)

Answer 2

• Insidious onset, progressive
  Primary features:
• Weakness and fatigue
• weight loss
• anorexia

Question 3

What are the secondary manifestations of Addison’s? (6)

Answer 3

• skin hyperpigmentation
• N+V
• hypotension
• diarrhea
• Irritability
• Depression

Note that not enough hormone, so ACTH is released more

Question 4

A complication of Addison’s is Addisonian crisis. What is that? (2)

Answer 4

• acute adrenal insufficiency
• Life threatening

Question 5

What is Addison’s triggered by? (4)

Answer 5

• stress
• sudden corticosteroid withdrawal
• adrenal surgery
• sudden pituitary gland destruction

Question 6

What are the severe manifestations of Addisonian crisis? (10)

Answer 6

Corticosteroid deficiencies
- hypotension
- tachycardia
- dehydration
- hyponatremia
- hyperkalemia
- hypoglycemia
- Fever
- Weakness and fatigue
- confusion that can lead to shock and circulatory collapse

Question 7

What are the GI manifestations of Addison’s? (3)

Answer 7

• N+V
• diarrhea
• abdominal pain

Question 8

What are the treatments for Addison’s?

Answer 8

• Shock management and aggressive hydrocortisone treplacement

Question 9

How is Addison’s diagnosed?

Answer 9

ACTH stimulation test

Question 10

With Addison’s, what would serum cortisol look like?

Answer 10

low

Question 11

What lab results would look abnormal with Addison’s? (6)

Answer 11

• hyperkalemia
• hyponatremia (lack of aldosterone)
• hypoglycemia (lack of cortisol)
• anemia (influence erythropoetin that stimulates RBC growth)
• Increased BUN
• Low urine cortisol and aldosterone

Question 12

EKGs with Addison’s may see arrhythmias. Why?

Answer 12

Hyperkalemia
- may also use CT and MRI to diagnose

Question 13

As stated before, what are the tx for Addison’s? (3)

Answer 13

Hydrocortisone replacement therapy
- dose needs to be increased with stress
- Increased salt in diet

Question 14

What implementations should a nurse do for someone with Addison’s? (2)

Answer 14

• frequent assessments
• Medications: Glucocorticoids and mineralocorticoids