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