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Addison's Disease, Screen Shot 2022-03-30 at 2.06.09 PM - Coggle…
Addison's Disease
Assessment Data
Hyponatremia (Hubert & VanMeter, 2018).
Hyperkalemia (Hubert & VanMeter, 2018).
Higher rates of infection (Hubert & VanMeter, 2018).
Lower than baseline body hair growth (Hubert & VanMeter, 2018).
Weight loss (Hubert & VanMeter, 2018).
Hyperpigmentation of the extremities (Hubert & VanMeter, 2018).
Chronic fatigue (Hubert & VanMeter, 2018).
Impaired stress response (due to deficient cortisol) (Hubert & VanMeter, 2018).
Decreased blood volume, pressure, and/or blood glucose (Hubert & VanMeter, 2018).
Anorexia (Hubert & VanMeter, 2018).
Cardiac dysrhythmias (Hubert & VanMeter, 2018).
Nursing Care
Client at increased risk for adrenal crisis associated with low ACTH and/or cortisol levels (Vera, 2022).
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Routinely assess ECG rhythm for signs of dysrhythmia associated with electrolyte imbalances such as hyperkalemia (Vera, 2022).
Monitor client's input, output, and weight - deficient aldosterone levels may result in a fluid volume deficit and rapid weight loss. (Vera, 2022).
Routinely assess client for signs and symptoms of hyperkalemia associated with deficient aldosterone levels such as: decreased energy levels (signs of fatigue), muscle weakness, and/or sensory deficits (Vera, 2022).
Routinely assess client's orthostatic vital signs for changes in blood pressure and heart rate (Vera, 2022).
Consult dietician and MRP to make meal plan that will be well-tolerated by client and potentially help correct both fluid volume and electrolyte imbalances in addition to other therapies (Vera, 2022).
Administer prescribed medications as directed. Common medications to treat Addison's disease are as follows: PO cortisone, prednisone, or fludrocortisone (Vers, 2022).
Client Education
Provide client education regarding the etiology and treatment of their condition (Vera, 2022).
Educate the client on the signs and symptoms associated with adrenal crisis (aka Addisonian Crisis) and when to seek medical attention (Society for Endocrinology, 2018).
Educate the client on the importance of dietary sodium. Additionally, the client should consider sodium supplementation in warm/hot environments where they might sweat and lose sodium at a faster than usual rate (Vera, 2022).
Educate client on the importance of adhering to lifelong steroid therapy to remain healthy, decrease or eliminate signs and symptoms of Addison's Disease, and to reduce the likelihood of adrenal crisis (Vera, 2022).
Provide education surrounding medication administration with an emphasis on medication timing. Steroids hormones like cortisol and aldosterone may stimulate the CNS and should be taken early in the day to prevent insomnia (Vera, 2022).
Adrenal Glands
Hormone production
Cortisol
Short-term boosts immunity by limiting the inflammatory response (Cleveland Clinic, 2021)
Increases and regulates blood sugar by inhibiting insulin production (Cleveland Clinic, 2021).
Regulates Metabolism through control of fat, protein, and carbohydrate usage (Cleveland Clinic, 2021).
Helps control sleep-wake cycle (Cleveland Clinic, 2021).
Regulates the body's stress response (Cleveland Clinic, 2021).
Aldosterone
Steroid hormone produced in the adrenal cortex (Society for Endocrinology, 2022).
Helps regulate blood pressure by increasing the rate of reabsorption of salt and water into the blood stream increasing blood volume and pressure (Society for Endocrinology, 2022).
Increases the amount of potassium excreted in urine (Society for Endocrinology, 2022).
Essential part of the RAAS pathway (Society for Endocrinology, 2022).
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Adrenal Disfunction
Etiology
Caused by the partial or complete destruction of the adrenal cortex (Hubert & VanMeter, 2018).
Causes for destruction of adrenal cortex include: autoimmune reaction, hemorrhage, bacterial infection, viral infection, fungal infection, or by a tumour (Hubert & VanMeter, 2018).
Destruction of the adrenal cortex results in systemic deficiencies of glucocorticoids (cortisol), mineralocorticoids (aldosterone), and androgens (Hubert & VanMeter, 2018).
In some cases, Addison's disease can be a result of infections like tuberculosis, abdominal injuries, generic defects, or surgeries involving the adrenal glands (Society for Endocrinology, 2018).
Also known as primary hypoadrenalism, adrenal failure, addison sundrome, adrenal insufficiency, or hypoadrenalism (Society for Endocrinology, 2018).
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