addison's disease

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 toacute 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 medicalalert band