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Nclex 26 Review: ADRENAL GLAND Disorders

ADRENAL GLAND DISORDERS

Addison’s Disease


– Hyposecretion of Adrenal Cortex Hormones

  • GLUCOCORTICOIDS
  • MINERALOCORTICOIDS

Assessment:

  • Nausea, vomiting, diarrhea.
  • Inability to cope with stress.
  • Moodiness, irritability, depression.
  • Lethargy, Fatigue
  • FATIGUE AND WEIGHT LOSS
  • HYPOTENSION
  • HYPOGLYCEMIA
  • HYPERKALEMIA
   * Hyperkalemia
   * Hypoglycemia
   * Patients with Addison’s Disease are usually fatigued due to low metabolic energy production.
   * Patients can also encounter a fluid deficit disorder to the decreased mineralocorticoid.
   ♣ STRESS can lead to an Addisonian Crisis.
   ♠ Remind patients to monitor their salt intake.
   ♦ To prevent hypotension, remind pt. to increase  sodium & fluid intake.
BE CAREFUL: Can lead to Addisonian Crisis

↓   Addisonian Crisis

Severe Mineralocorticoid Deficiency.

Addisonian Crisis Assessment

  • SEVERE HEADACHE

    WEAKNESS AND IRRITABILITY

    SEVERE HYPOTENSION

    SHOCK

Treatment (Meds)

Corticosteroids (Glucocorticoids)
  • Suppresses Inflammation
  • An Anti-inflammatory
  • Used for Adrenocortical Insufficiency
Side Effects:
  • Hypokalemia
  • Hyperglycemia
  • Edema
  • Water Retention

CUSHING’S SYNDROME

Cushing’s Syndrome

An excess of cortisol.

What is Cortisol:

  • A steroid hormone
  • a glucocorticoid
  • produced by the adrenal gland.
  • Released in response to stress.
  • Primary functions are to increase blood sugar.
  • Suppresses the immune system.

ASSESSMENT:

  • Upper body obesity
  • Thin arms and legs
  • Severe fatigue and muscle weakness
  • High blood pressure
  • High blood sugar
  • Easy bruising
Buffalo Hump: thin extremities, obese truncal area
Low-dose dexamethasone suppression Test:
  ↑ is done to DIAGNOSE Cushing’s Syndrome.
    ♦ Patient is susceptible to injury or infection.
TREATMENT:
  • If caused by a tumor: Surgery may be necessary.
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