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Addisons Disease (Nursing Care Plan)

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Overview -
Hyposecretion of adrenal cortex hormones
Decreased levels of glucocorticoids and mineralocorticoids leads to
- Electrolyte imbalances
- Decreased vascular volume
Fatal if untreated

Nursing Points

General -

Adrenal Cortex
- Glucocorticoids
- Cortisol
- Glucose & Fat Metabolism
- Anti-inflammatory
- Mineralocorticoids
- Aldosterone
- Regulate fluid and electrolytes
- Sex hormones (Androgens)
- Testosterone, Estrogen
- Control physical features
- Control hair distribution
- Adrenal Medulla
- Epinephrine (Adrenaline)
- Norepinephrine (Noradrenaline)
- Fight or Flight Response

Assessment

Cardiovascular
- Hypotension
- Tachycardia

Metabolic
- Weight loss

Integumentary
- Hyperpigmentation (bronzing)

Electrolytes
- Hyperkalemia
- Hypercalcemia
- Hyponatremia
- Hypoglycemia

Addisonian Crisis
- Acute exacerbation
- Severe electrolyte disturbance

Therapeutic Management of Addisons Disease

Replace adrenal hormones
Corticosteroids
Hydrocortisone
Prednisone
Addisonian Crisis
Monitor electrolytes and cardiovascular status closely
Administer adrenal hormones as ordered
Administer electrolyte replacement as needed

Nursing Concepts

Fluid & Electrolytes
Monitor Vital Signs
Monitor electrolytes (potassium, sodium, calcium)
Replace electrolytes as needed
Hormone Regulation
Administer replacement adrenal hormones as needed
Lifelong medication therapy needed
Glucose Metabolism
Monitor glucose levels
Treat low blood sugar
Patient Education
Increase salt and water intake if exercising
S/s of Addisonian Crisis
May require increased medication dosing if ill, notify provider
Reference Links
MedScape
Wikipedia
Mayo Clinic. (2017). Addison’s disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293






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