Scribd Logo
Upload

Welcome to Scribd!

  • 1 views

    Addison's Disease

    Uploaded by

    anadidita1000

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Addison's Disease

    Uploaded by

    anadidita1000
    1 views2 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    1 views2 pages

    Addison's Disease

    Uploaded by

    anadidita1000

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    IVY TECH COMMUNITY COLLEGE OF INDIANA

    NURSING PROGRAM
    NSG 105 – Medical-Surgical I Clinical
    Pathophysiology & Diagnostic Tests Activity

    Medical Diagnosis: Addison’s Disease (Primary Adrenal Insufficiency)


    Pathophysiology: Consistent insufficient production of cortisol and aldosterone by the
    adrenal glands, resulting in the progressive destruction of the adrenal cortex. Over 70%
    of Addison’s diagnoses are autoimmune in nature, with the body attacking its own tissues
    (adrenal glands). TB, AIDS and hemorrhage into the adrenals are also associated with the
    destruction of the adrenal glands.

    Manifestations: Typically slow onset with symptoms manifesting after 90% of gland is
    destroyed. ACTH levels ↑ while aldosterone and cortisol ↓. Cortisol deficiency leads to
    hypoglycemia which can cause muscle weakness and fatigue; weight loss and decreased
    appetite; low blood sugar; low B/P; mood changes such as depression, irritability.
    Aldosterone deficiency affects the kidneys’ ability to conserve sodium (hyponatremia)
    which can cause dizziness, confusion and neuromuscular irritability and hyperkalemia.
    Too much K in the blood can cause cardiac dysrhythmias. > 90% of Addison’s patients
    experience hyperpigmentation of their skin, while 50% c/o of nausea, diarrhea and
    vomiting.

    Diagnostic tests used in diagnosing Addison’s Disease include:


    1. The ACTH (Adrenocorticotropic hormone) Stimulation Test measures the level of
    cortisol in a pt’s blood before and after an injection of synthetic ACTH (the
    primary stimulator of cortisol production by the pituitary gland). With Addison’s
    disease, this test will show a decreased (or non-existent) output of cortisol. This is
    the standard diagnostic test for Addison’s Disease and is also used to diagnose
    other pituitary and adrenals disorders such as Cushing’s Disease and
    Hypopituitarism. Normal baseline ACTH levels are 20-30 mg/dL. Patients with
    Addison’s Disease have baselines well-below 10 mg/dL.

    2. The Insulin-Induced Hypoglycemia Test measures how the hypothalamus,


    pituitary and adrenal glands respond to the stress of induced hypoglycemia. Blood
    is drawn to measure the blood glucose and cortisol levels before and after an
    injection of fast-acting insulin. Blood glucose and cortisol levels are measured
    again 30, 45 and 90 minutes after the insulin injection. Normal a.m. Cortisol
    levels are 5-23mg/dL and normal glucose levels are 70-100 mg/dL. Both glucose
    and cortisol levels will be below normal levels in Addison’s pts.

    Nursing Diagnosis:
    1. Actual Diagnosis: Deficient Fluid Volume
    r/t decreased aldosterone secretion, nausea, vomiting and diarrhea
    AEB: orthostatic hypotension; weakness, fatigue, frequent urination; craving of
    salt; diaphoresis.
    2. Potential Diagnosis: Risk for infection
    r/t compromised immune function, altered metabolism, decreased stress
    tolerance.
    References

    Carpenito, L. J. (2013). Nursing diagnosis: Application to clinical practice (14th ed.,

    pp. 353-359). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams &

    Wilkins.

    Cihakova, D. (2000). Diseases: Johns Hopkins Autoimmune Disease Research Center.

    Retrieved October 27, 2014, from

    http://autoimmune.pathology.jhmi.edu/diseases.cfm

    LeMone, P., Burke, K. M., & Bauldoff, G. (2011). Medical-surgical nursing: Critical

    thinking in patient care (5th ed., pp. 510-516). Upper Saddle River, NJ: Pearson.

    You might also like