THE NCLEX CHANNEL

{ Addison Disease and Cushing Syndrome}

Session Objectives:
· Objective 1 - Review the pathophysiology and clinical manifestations of Addison disease and
Cushing syndrome.
· Objective 2 - Identify diagnostic tests and treatments for Addison disease and Cushing
syndrome.
· Objective 3 - Review nursing interventions for Addison disease and Cushing syndrome.

Points of Emphasis:
• The adrenal gland produce STEROIDS (Glucocorticoids/Mineralocorticoids/Androgens [sex
hormones]).
• Cushing syndrome and Addison disease diagnosed with cortisol testing (plus additional tests).
• When a disease or medication makes you RETAIN excessive Na+, the body EXCRETES K+ to
compensate -> hypokalemia.
o Addison disease: hyponatremia, hyperkalemia
o Cushing syndrome: hypernatremia, hypokalemia
• Note that Cushing symptoms are very similar to adverse effects associated with steroids
(makes it easy to predict symptoms).
• Client with Addison disease will require lifelong hormone replacement (fludrocortisone,
hydrocortisone).
• Treatment for Cushing syndrome: transsphenoidal hypophysectomy.

References:
Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing (14th
ed.). Philadelphia, PA: Wolters Kluwer.

Ignatavicius, D. D., & Workman, M. L. (2016) Medical-surgical nursing: Patient-centered collaborative

care (8th ed.). St. Louis, MO: Elsevier Saunders.

Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical-surgical nursing:
Assessment and management of clinical problems (10th ed.). St. Louis, MO: Elsevier.