Report Addison Padilla

7/29/2019 Report Addison Padilla

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Review :

In 1855, Thomas Addison,an Englishphysician,provided the first clinical detailed

description of the disease.

Also known as adrenal insufficiency.

An endocrine disorder characterizedby inability of adrenal gland to produce

enough of its hormone.





Adrenal Cortex (Layers)

Zona Glomerulosa

Zona Fascicularis

Zona Reticlaris

Aldosterone

Cortisol

Androgen



Addison’s Disease

-Adrenal Glands do not produce sufficient

steroid hormones.(glucocorticoid and

mineralcorticoid)

-Occurs at any age(most common in adults age of 60.

-Most common in woman



Causes :

Autoimmune destruction of adrenals. Tuberculosis

Abrupt withdrawal from long-term,high steroid therapy

Surgical removal of both adrenal glands or infection.

Cancer of adrenals, Aids



Pathophysiology: Addison’s disease

Autoimmune destruction

of adrenals. Tuberculosis

Abrupt withdrawal from long-term,high steroid therapy

Surgical removal of both adrenal glands or infection.

Cancer of adrenals, Aids

Results to massive destruction of adrenal gland

Leads to rapid decline in steroid hormones

cortisol and aldosterone



Cortisol

Decrease secretion

of glucocorticoid

Decrease bld.glucose

Leads to Hypoglycemia

Aldosterone

Decrease secretion of

mineralcorticoid

Affects the ability of the

Distal tubules of the

nephron to conserve

Sodium

Sodium loss

Decrease Na+ leveldehydration





S/Sx

Fatigue ,muscle weakness

Anorexia,nausea and vomiting.wt.loss

Hypoglycemia

Bronze pigmentation

Inability to cope with stress



Diagnostic Studies

Cortisol level blood test

X-ray of Adrenal gland

Blood glucose level ACTH level



Nursing Diagnosis :

Deficient Fluid Volume

Activity Intolerance

Knowledge Deficit

Disturbed body image



Management :

Administration of fluids and corticosteroid.

Antibiotic for infection.

Monitor Vital signs,I and O Monito wt.

Monitor Urine and Blood glucose.

Rest



Addisonian Crisis

Is a life-threatening response to acute

adrenal insufficiency.

This response occur in any person withaddison’s disease.

Most commonly precipitated by major

stressors,especially if the disease is poorly

controlled.



Risk Factors for adenal crisis:

Patient who do not respond to hormone

replacement therapy.

Patient who experience extreme stress withoutadequate glucocorticoid replacement.

Abruptly stop hormone therapy

Experience trauma

Undergo bilateral adrenalectomy



Addisonian crisis have any of the manifestationof addison’s disease.

Primary symptoms are

High fever

Weakness and fatigue Abdominal pain

Severe hypotension

Circulatory collapse

Shock

Coma



Treatment :

Rapid intravenous replacement of fluids

and corticosteroid. Fluid balance is usually restored in

4 to 6 hours.



Question :

1.A client is admitted into the emergencydepartment with Addisonian crisis.Which

of the following should the nurse be prepared

to administer to assist the client?

a.Thyroid replacement hormone

b. Intravenous fluids

c. Blood transfusion

d. Warm blankets



2. Which statement illustrates that the client with

Addison’s disease understands your teaching?

a.”I wonder why I look suntanned all the time.”

b.”I will stop taking my medications when I have

an infection.”

c.”I know I should never alter my dose of medication.

d.”I have purchased an emergency kit and keep it

with me all the time.”



3. Which of the following layers of adrenal cortex

produces hormone Cortisol?

a.Zona Reticularis

b.Zona Fesicularis

c.Zona Glomerulosa

d.Zona Fascicularis



4.A nurse know that a client with addison’s disease

has _______Sodium and Potassium_________ .

a.Increased,Decreased

b.Decreased,Increased

c.Increased,Increased

d.Decreased,Decreased



5.The nurse knows that o ne of the risk factor

for addisonian crisis is________.

a.Advance Maternal

b.Abruptly stop hormone therapy

c.Poor nutritiond.low-socio economic status



6-7. List 2 nursing diagnosis for Addison’s Disease.

8-10. List 3 primary symptoms of Addisonian Crisis.

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Report Addison Padilla

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