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Addidons disease

QuestionAnswer
what is Addison's HYPOsecretion of adrenal cortex hormones--Glucocorticoids & mineralcorticoids, fatal if left untreated
Addison's Signs/Symptoms weakness, wt loss, GI probs, HYPOtension, bronze pigmentation of skin, emotional disturbances
Addison's--Causes autoimmune TB, metastic cancer, fungal lesion, AIDS, Hemorrhage, Adrenalectomy, abd radiation therapy (abd, head), drugs (mitotane) toxins
Addison's--electrolyte imbalance--Sodium & Potassium HYPOnatremia & HYPERkalemia
what causes the bronze pigmentation of the skin? increased MSH (melanlocyte-stimulating hormone)
Addison's--ACTH & MSH levels ACTH & MSH are elevated
what is the difference in primary & secondary in reference to skin? In secondary there is no change in skin pigmentation
In primary, what other labs are elevated? eosinophil count & ACTH are elevated
What is the most definitive test for adrenal insufficiency? ACTH stimulation test
ACTH stumlation test is perfomed-- on an outpatient basis
ACTH stimulation test--what is given & what is obtained? ACTH 0.25 to 1mg given IV; & cortisol levels are obtained at the 30min & 1hr intervals
ACTH stimulation test--in primary the cortisol levels are_____in secondary the cortisol levels are ______ primary cortisol levels--absent/markedly low secondary levels are increased
Addison's--imaging assessments Skull Xray, CT, MRI, & ateriography are used to determine cause of pituitary probs leading to adrenal insufficiency
Addison's--What does the CT of the adrenal gland show? CT scans of adrenal gland might show athropy gland
Nursing intervention goals-- promote fluid balance, monitor for fluid deficit, prevent hypoglycemia, daily weights, I&O, V/S q1-4hrs; monitor labs
What is given to to correct glucocorticoid deficiency? Hydrocortisone
How is hydrocortisone given? divided doses--2/3 given in the am & 1/3 in late afternoon to mimic normal release of hormone
what minercorticoid may be given & why? Florinef--may be needed to maintain electrolyte balance
What might be given PO salt
Addisonian crisis life threatening; need for cortisol & aldosterone is greater than supply
Addisonian crisis occurs in response to-- stressful events--surgery, trauma, severe infections; esp when hormone output is already reduced
Unless intervention is initiated quickly-- Sodium falls & potassium rises rapidly--more severe hypotension
Addisonian crisis--more severe hypotension results from blood volume depletion that occurs withthe loss of aldosterone
Addison's--neuromuscular manifestations muscle weakness, fatigue, joint/muscle pain
Addison's GI manifestations Anorexia, N/V, Abd pain, diarrhea/constipation, wt loss, salt craving
Addison's integumentary manifestations Vitiligo (white patches), hyperpigmentation
Addison's--cardio manifestations anemia, Hypotension, Hyponatremia, Hyperkalemia, HyperCalemia
Addison's--Sodium decreased
Addison's--Potassium Increased
Addison's--Glucose normal to decreased
Addison's--Calcium Increased
Addison's--BUN Increased
Addison's--Cortisol Decreased
Addison's--Bicarb Increased
Created by: DitziDame