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Addison's

Addison's

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Published by KoRnflakes

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Published by: KoRnflakes on Jan 21, 2009
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05/10/2014

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ADRENOCORTICAL INSUFFICIENCY [Addison’s Disease]
PathophysiologySigns and Symptoms
Muscle weakness
Anorexia
Gastrointestinal symptoms
Fatigue
Emaciation
Dark pigmentation of skin, knuckles, knees, elbows, and mucousmembranes
Hypotension
Low blood glucose levels
Low serum sodium levels
High serum potassium levels
Mental status changes
 
Inadequate adrenal cortexfunctionSurgicalremoval of adrenal glandsAutoimmunedisorder, Idiopathicatrophy, TB andhistoplasmosis
Adrenocortical Insufficiency
Cortecosteroidand suddencessation of exogenousadrenocorticalhormonalInadequatesecretion of ACTH from thepituitary gland
 
Depression
Emotional lability
Apathy
Confusion
Addisonian crisis
Cyanosis
Classic signs of circulatory shock:
Pallor
Apprehension
Rapid and weak pulse (Tachycardia)
 Tachypnea
Hypotension
Assessment and Diagnostic Findings
Laboratory findings:
Hypoglycemia
Hyponatremia
Hyperkalemia
Leukosytosis
Low level of adrenocortical hormones in blood or urine anddecreased serum cortisol levels
Medical Management
1.Prevent circulatory shocka.Restore blood circulationb.Administer fluids and corticosteroidsc.Monitor vital signsd.Place the patient in a recumbent position with legselevatee.Administer hydrocortisone (Solu-Cortef) intravenouslyfollowed by 5% dextrose in normal salinef.Vasopressor amines – if hypotension persistsg.Antibiotics – if infection occurs
Nursing Management
a.Vital signs monitoringb.Assess skin color and turgorc.Assess history of weight changes, muscle weakness, andfatiqued.Ask about onset of illnesse.Restore fluid balance
 
Addison’sDiseaseCushing’s Syndrome
SugarHypoglycemiaHyperglycemiaSaltHyponatremiaHypernatremiaSexDecreased libidoSexual urge not merelyaffectedPotassiumHyperkalemiaHypokalemiaPhysicalappearanceNot seen, more onsymptomsBuffalo hump, moonface,pitting edema, hirsutism,breast atrophy, purple striae onabdomen, easy bruising, facialflushing, acne,hyperpigmentationDietHigh Na, CHON, CHOintake except K Low Na, CHO, fats but highCHON and K intake
DKA (DiabeticKetoacidosis)HHNS (HyperglycemicHyperosmolar NonketoticSyndrome)
Acute complication of type1 DMdue to severe hyperglycemia,leading to CNS depression & comaHyperglycemia w/o ketosis iscommonly on DM type2Polyuria, Polydipsia, Polyphagia,Glycosuria, PathognomonicSx:>acetone breath– fruity odor>kussmul’s respiration– rapid,shallow breathingHypotension, extreme thirst,dehydration, tachycardia,hypokalemia, hyponatremiaMx: monitor VS; I/OMeds: Insulin therapy (IV),counteract acidosis – Na HCO3 Tx: give insulin, inc. fluid

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