Addisons disease concept map PDF

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Summary

Download Addisons disease concept map PDF

Description

Disease: Adrenocortical Insufficiency Etiology: -

Addison’s disease: all 3 classes of corticosteroids are reduced Secondary adrenal cortical insufficiency: corticosteroids and androgens are deficient but not mineralocorticoids Lack of ACTH secretion Autoimmune polygladular syndrome

Causes of Addison’s disease: -

Autoimmune adrenalitis Tuberculosis Amyloidosis Fungal infection AIDS Metastatic cancer

Iatrogenic Addison’s disease: -

Adrenal hemorrhage

S/S: -

Often advanced at diagnosis Anorexia Nausea Progressive-severe weakness/fatigue Weight loss Increased ACTH causes hyperpigmentation Abd pain Diarrhea Headache Orthostatic hypotension Salt craving Joint pain Irritability Depression

Complications: -

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Addisoninian crisis(emergency) o Triggered by stress, sudden withdraw from corticosteroid hormone therapy, adrenal surgery, sudden pituitary land destruction Severe manifestations of glucocorticoid and mineralocorticoid deficiencies o Hypotension(can lead to shock o Tachycardia o Dehydration o Hyponatremia o Hyperkalemia o Hypoglycemia o Fever o Weakness o confusion GI manifestations o Vomiting o Diarrhea o Pain in abd o Pain in lower back or legs

Dx studies: -

ACTH stimulation test Baseline cortisol and ACTH levels are measured People with Addison’s have little or no cortisol Corticotrophin-releasing hormone (CRH) stimulation test High ACTH levels ECG MRI CT scan

Lab findings: -

Hyperkalemia Hypochloremia Hyponatremia Hypoglycemia Anemia Increased BUN ECG showing low voltage and peaked T waves caused by hyperkalemia

Interprofessional care: 49-16 -

Lifelong hormone therapy Dosages increased in stressful situations Increased salt added to diet Managing and treating shock Reversing hypotension Fixing electrolyte imbalances Managing BP

Nursing care: Acute: -

Monitor F&E balance Assess vital signs Assess neuro status Assess signs of fluid volume deficit and electrolyte imbalance Record I&O Obtain daily weight Complete med history Note changes Guard pt against infection Assist with daily hygiene Protect pt from noise, light, and environmental temperature extremes because pt cannot cope with these stressors

Ambulatory care: -

Glucocorticoids given in divided dose Mineralocorticoids given once daily preferably in the morning Teach pts on this therapy to take BP, increase salt intake, and report any significant findings Stress management due to decreased stress tolerance Adjusting dosage to deal with stress episodes Electrolyte replacement and parenteral administration If vomiting or diarrhea occurs pt should notify HCP Teach pt the signs and symptoms of corticosteroid deficiency Pt should wear an ID bracelet and an ID for Addison’s in wallet Carry an emergency kit Teach pt, caregiver, and significant others how to give an IM injection.

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