LABORATORY &

DIAGNOSTICS
 Test Result Reference Value
CT Scan
Computerized tomography scan of your
abdomen to check the size of your adrenal
glands and look for other abnormalities.
Cortisol Level Test
Uses a blood sample to measure the level of 4.5 6-23 mcg/dL @ 8am
cortisol present in your blood. Cortisol is a mcg/dL Low
steroid hormone released by the adrenal
glands.
ACTH (Adrenocorticotropic Hormone)
Stimulation Test
This is the most specific test for diagnosing 54
Addison's disease. Measures the levels of both 9-52 pg/mL @ 8am High
pg/mL
ACTH and cortisol in the blood. Helps to
distinguish primary from secondary adrenal
insufficiency
 Test Result Reference Value
Serum Aldosterone Test
An aldosterone test measures the 2-9 ng/dl (55 - 250 Low
level of aldosterone (a hormone 1 ng/dL pmol/L) @ supine
made by the adrenal glands), in the position
blood.
Electrolyte Panel Test
A blood test that measures levels of Na: 125 mmol/L Na: 135-145 mEq/L Low
the body's main electrolytes: Na, K, K: 5.5 mmol/L K: 3.5-5.0 mmol/l High
HCO3: 15 mmol/L HCO3: 21-28 mEq/L Low
and HCO3.
Urinalysis Specific Gravity Test
Urine specific gravity is a laboratory 1.025 1.002 and 1.030 Significant
test that shows the concentration dehydration
of all chemical particles in the urine.
BUN (Blood Urea Nitrogen) Test
Measures the amount of nitrogen in 27 mg/dL 7-20 mg/dL High
your blood that comes from the
waste product urea.
 Test Result Reference Value
Creatinine Test
A creatinine test is a measure of 0.66-1.25 mg/dL
how well your kidneys are 1.29 mg/dL High
performing their job of filtering
waste from your blood.
Blood sugar level
Is a procedure that measures the 3.3 mmol/L 4-8mmol/L Low
amount of sugar, or glucose, in your
blood.
PHARMACOLOGY
 Generic Name, Indication,
Drug Name
Mechanism of Action
Cortef Generic Name: Hydrocortisone
Indication: Endocrine Disorders
(Congenital adrenal hyperplasia, Non
suppurative thyroiditis, and hypercalcemia
associated with cancer)
Mechanism of Action: Glucocorticoids
inhibit neutrophil apoptosis and
demargination; they inhibit phospholipase
A2, which decreases the formation of
arachidonic acid derivatives; they inhibit
NF-Kappa B and other inflammatory
transcription factors; they promote anti-
inflammatory genes like interleukin-10.
Nursing Consideration
• Monitor signs of
hypersensitivity reactions or
anaphylaxis, including
pulmonary symptoms
(tightness in the throat and
chest, wheezing, cough,
dyspnea) or skin reactions
(rash, pruritus, urticaria).
• Assess any muscle or joint
pain.
Contraindications: Systemic
fungal infections, Patients with
known hypersensitivity to
hydrocortisone or components of
the tablet, Herpes simplex of the
eye, except when used for short-
term or emergency therapy, Live
vaccination
 Drug Name Generic Name, Indication,
Mechanism of Action
Florinef Acetate Generic Name: Fludrocortisone
Indication: Indicated as partial
replacement therapy for primary and
secondary adrenocortical
insufficiency in Addison's disease
Mechanism of Action: Increases
extracellular and intravascular volume
by increasing sodium reabsorption by
the kidney, thus increasing cardiac
output and standing blood pressure
and increase the urinary excretion of
both potassium and hydrogen ions.
Nursing Consideration
• Monitor blood pressure and signs of
edema when patient is on chronic
therapy
• Monitor serum electrolytes, serum renin
activity, and blood pressure
• Monitor evidence of infection
• Closely monitor patients with Addison's
disease and stop treatment if a
significant increase in weight or blood
pressure, edema or cardiac enlargement
occurs
Contraindications: In patients with systemic
fungal infections and in those with a history
of possible or known hypersensitivity to
these agents.
 Drug Name Generic Name, Indication,
Mechanism of Action
Oral Rehydration Generic Name: -
Salt (ORS)
Indication: Used to replace fluids and
electrolytes
Mechanism of Action: Uses the
sodium-glucose cotransport
mechanism to passively absorb water
across the intestinal mucosa.
Nursing Consideration
• Assess vital signs, noting peripheral
pulses.
• Monitor blood pressure and invasive
hemodynamic parameters.
• Strictly monitor intake and output.
• Instruct patient to use only water to mix
with the oral rehydration salts.
Contraindications: Known hypersensitivity
to medicines containing potassium, sodium,
citrates, rice or sugar.
 Drug Generic Name, Indication, Nursing Consideration
Name Mechanism of Action
Deltasone Generic Name: • Check and record BP during dose stabilization
Prednisone period at least 2 times daily. Report an ascending
pattern.
Indication: to give you the • Monitor for withdrawal syndrome (e.g., myalgia,
minimum amount of fever, arthralgia, malaise) and hypocorticism (e.g.,
glucocorticoid needed to anorexia, vomiting, nausea, fatigue, dizziness,
replace your body’s normal hypotension, hypoglycemia, myalgia, arthralgia) with
cortisol production abrupt discontinuation of corticosteroids after long-
term therapy.
Mechanism of Action: • Monitor bone density. Compression and
Prednisone is a synthetic spontaneous fractures of long bones and vertebrae
glucocorticoid that has both present hazards, particularly in long-term
anti-inflammatory and corticosteroid treatment of rheumatoid arthritis or
immunomodulating diabetes, in immobilized patients, and older adults.
properties.
Contraindications: Systemic fungal infections and
known hypersensitivity; pregnancy (category C),
lactation
 Drug Generic Name, Indication,
Name Mechanism of Action
Glucagen Generic Name: Glucagon
Indication: indicated as a
treatment for severe
hypoglycemia (low blood
sugar)
Mechanism of Action:
Stimulates cAMP synthesis
to accelerate hepatic
glycogenolysis and
gluconeogenesis, causing
an increase in blood
glucose levels. Preexisting
hepatic glycogen stores
necessary to be effective in
treating hypoglycemia
Nursing Consideration
• Perform a complete physical assessment to
establish a baseline before beginning therapy,
monitor effectiveness of therapy, and evaluate for
any potential adverse effects during therapy.
• Monitor blood glucose levels as ordered to assess
the effectiveness of the drug and patient response
to treatment.
• Assess orientation and reflexes and baseline pulse,
blood pressure, and adventitious sounds to monitor
the effects of altered glucose levels, and abdominal
sounds and function, which could be altered by
these drugs.
Contraindications: Glucagon is contraindicated in
patients with known hypersensitivity to it or in patients
with known pheochromocytoma. Glucagon should be
administered cautiously to patients with a history
suggestive of insulinoma, pheochromocytoma, or both.
 Drug Generic Name, Indication,
Name Mechanism of Action
Lustra Generic Name:
Hydroquinone
Indication: is a skin-
lightening agent. It bleaches
the skin, which can be helpful
when treating different forms
of hyperpigmentation.
Mechanism of Action:
produces reversible lightening
of the skin by interfering with
melanin production by the
melanocytes. Specifically,
inhibition of the enzymatic
conversion of tyrosine to
DOPA
(dihydroxyphenylalanine)
results in the desired chemical
reduction of pigment.
Nursing Consideration
• Caution patient to avoid contact with the eyes
and not to use on open lesions, sunburned,
irritated, or otherwise damaged skin.
• Caution the patient to wash drug off if rash or
irritation develops and consult physician.
• Monitor for therapeutic effectiveness: In general,
complete depigmentation occurs in 1–4 mo and
lasts 2–6 mo after hydroquinone is discontinued.
Once desired results are obtained, reduce
amount and frequency of applications to the least
that will maintain depigmentation.
Contraindications: Prior history of sensitivity or
allergic reaction to hydroquinone or to any of the
ingredients of the product.