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JM Addison Disease
Primary Adrenocortical Deficiency
| Question | Answer |
|---|---|
| What is Addison Disease? | Autoimmune process commonly found in conjunction with other endocrine diseases. A hyposecretion of adrenal cortex hormones. |
| Explain function of one of the adrenal cortex hormones. | Glucocorticoids: Cortisol, cortisone, corticosterone: carb, fat,protein metabolism,F/E Balance,suppresses inflammatory response, protective immune to infectious agents, resistance to stress. |
| Explain function of one adrenal cortex hormone. | Mineralocorticoids: Aldosterone-regulation of electrolyte balance by promoting Na+ retention and k+excretion. |
| What is Addison Disease characterized by? | Lack of cortisol, aldosterone, and androgens. Think: sugar, salt, and sex |
| How is the definitive diagnosis made for Addison Disease? | Using an ACTH stimulation test |
| What is secondary Addison Disease caused by? | ACTH production by the anterior pituitary failing. |
| What teaching should be incorporated for pts prescribed steroids? | The importance of following prescribed regimen precisely. Meds SHOULD NOT be stopped suddenlneed to taper off |
| What are some nursing assessments for Addison Disease? | Fatigue, weakness, N/V,anorexia,wtloss,postural hypotension, hypoglycemia,hyponatremia, hyperkalemia, hyperpigmentation (only in primary Addison),HYPOVOLEMIA:HYPOTENSION,TACHYCARDIA,FEVER. POSSIBLE SHOCK W/ADDISON'S CRISIS,loss of body hair. |
| What is Addison crisis: | MEDICAL EMERGENCY. Brought on by sudden withdrawal of steroids,a stressful events(trauma, severe infection) |
| What are the characteristics of Addison crisis? | Vascular collapse-hypotension,tachycardia,hypoglycemia |
| What interventions are done for Addison crisis? | IV fluids at rapid rate until stabilized,IV glucose, parenteral hydrocortisone, aldosterone replacement |
| What are signs of shock with Addison crisis? | Early signs of shock are agitation and restlessness resulting from cerebra hypoxia. See pg 29-30 in Hesi book |
| What are nursing assessments for Addison disease? | Fatigue,N/V,anorexia, wt loss,hypoglycemia,hypoNa+,hyperK+,hyperpigmentation(only if primary),signs of shock, loss of body hair, hypovolemia-hypotenstion,tachycardia,fever |
| Name two nursing diagnosis for Addison Disease. | Deficient fluid volume r/t, deficient knowledge r/t |
| What nursing plans and interventions should be carried out for Addison Disease? | V/S frequently (ql5 when in crisis), I&Os, daily wt,rise slowly,administer IV glucose with parenteral glucocorticoids,it requires large fluid vol replacement. |
| What does nurse need to teach pt with Addison disease? | Need for lifelong hormone replacement, medical supervision, medicaler, S/S of overdosage/underdosage of meds,diet (highNa+,lowK+, highcomplex carbs),fluid-3Lqday |
| What prophylaxis should be provided for pt with Addison disease? | Ulcer prophylaxis |
| What is considered secondary Addison disease? | If ACTH production by the anterior pituitary has failed. |
| What is ACTH? | A hormone that stimulates adrenal glands to produce cortisol. Produced by the anterior pituitary. |
| Name the adrenal cortex hormones and their functions. | Glucocorticoids: Cortisol,Cortisone,Corticosterone-glucose,protein metabolism;F/E balance,suppression of infammatory response to injury,protective immune response to infectious agents,resistance to stress. |
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