Addisonian Crisis - ATI template on disease process PDF

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Summary

ATI template on disease process...

Description

ACTIVE LEARNING TEMPLATE:

System Disorder

ST UDENT NAME _____________________________________

Addisonian Crisis DISORDER/DISEASE PROCESS __________________________________________________________

Alterations in Health (Diagnosis) Addisonian crisis is a life-threatening condition in which the body's demand for cortisol and aldosterone exceeds its supply.

Pathophysiology Related to Client Problem It often happens as a result of a traumatic event such as surgery, trauma, or a serious infection, particularly if the adrenal hormone production is already low.

REVIEW MODULE CHAPTER ___________

Health Promotion and Disease Prevention Patients with primary adrenal hypofunction or Addison's disease must take cortisol replacement on a daily basis. During periods of stress, increase replacement hormone dosages.

ASSESSMENT

SAFETY CONSIDERATIONS

Risk Factors

Expected Findings

• Tuberculosis • Metastatic cancer • HIV-III (AIDS) • Hemorrhage • Gram-negative sepsis • Adrenalectomy • Abdominal radiation therapy • Drugs (mitotane) and contaminants • Adrenalectomy • Abdominal radiation therapy

Laboratory Tests

The symptoms of lethargy, exhaustion, and muscle weakness are common. salt cravings are common in hypofunctioning people.

Diagnostic Procedures

The Adrenal Gland Assessment: Low serum sodium and salivary cortisol levels, low fasting blood glucose, elevated potassium, and high blood urea nitrogen (BUN) levels, Eosinophil count and ACTH levels are both elevated in primary disease. During provocation tests, plasma cortisol levels don't rise.

CT and MRI are extremely useful. Adrenal gland atrophy can be seen on CT and MRI scans, but not the cause.

PATIENT-CENTERED CARE

Nursing Care The critical care nurse role includes: inserting a nasogastric tube to treat vomiting if aspiration is a concern due to a decreased level of consciousness. providing ongoing reorientation for confused individuals as well as ensuring a safe environment through one-on-one sitters for agitated individuals. Reduce physiologic and emotional stressors, as these will raise the risk of

Therapeutic Procedures - patient cortisol and aldosteron levels stabilized. - patient informed of lifelong therapy

ACTIVE LEARNING TEMPLATES

Neuromuscular Symptoms • Muscle weakness • Fatigue • Joint and/or muscle pain Gastrointestinal Symptoms • Anorexia • Nausea, vomiting • Abdominal pain • Constipation or diarrhea • Weight loss • Salt craving Skin Symptoms • Vitiligo or • Hyperpigmentation Cardiovascular Symptoms • Anemia • Hypotension • Hyponatremia • Hyperkalemia • Hypercalcemia

Complications Medications Start a rapid infusion of normal saline or dextrose in normal saline at 5%. • Higher doses of hydrocortisone sodium or dexamethasone are given as an IV bolus at first. • Continue administering hydrocortisone sodium via IV infusion for the next 8 hours. • Start an H2 histamine blocker (e.g., cim) and give an additional dose of hydrocortisone IM concomitantly with hydration every 12 hours.

Client Education Patients can appear lethargic, depressed, confused, or even psychotic, depending on the severity of the imbalance. Examine the patient's sense of person, place, and time. Families can report the patient's mood swings and forgetfulness.

Interprofessional Care Addisonian crisis is is a medical emergency that must be treated quickly. Death is the result of ineffective management.

Extremely low blood pressure Pain in the stomach, back, and legs that comes on suddenly Shock from Syncope Severe nausea, diarrhea, and headache Hyponatremia Hyperkalemia Hypoglycemia

THERAPEUTIC PROCEDURE

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