Addison’s Disease


Etiology and Pathophysiology

■ An adrenocortical disorder exhibited by
↓secretion of adrenocortical hormones → ↓glucocorticoids, mineralocorticoids (aldosterone), and androgens, which → ↓stress response

■ Occurs secondary to surgical removal of adrenal glands, autoimmune or idiopathic causes, abrupt cessation of steroid therapy, or infection

Signs and Symptoms

■ ↑K, ↓Na, dehydration, ↓serum glucose, weakness, diarrhea, confusion

■ ↓BP, ↓weight, bronze-colored skin

■ ↑ACTH, ↓serum cortisol, ↓17-ketosteroids, ↓17-hydroxysteroids

■ Addisonian crisis: Pallor or cyanosis, anxiety, ↑P, ↑R, ↓BP secondary to
acute stress (surgery, emotions, cold exposure, infection)

Treatment

■ Glucocorticoid and mineralocorticoid replacement (↑dose under stress to ↓risk of Addisonian crisis)

■ F&E replacement

Nursing Management

■ Monitor for S&S of Addisonian crisis

■ Encourage ↑protein and ↑carbohydrate diet with added salt

■ Schedule rest periods

■ Teach need for lifelong therapy, avoidance of stress, and use of medical
alert band
addison's dse nursing management, Addisonian crisis,
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