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what is Addison's
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Addison's Signs/Symptoms
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Addidons disease
| Question | Answer |
|---|---|
| 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 |
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DitziDame
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