Signs &
Symptoms
*Neuro
• Muscle weakness
• Fatigue
• Joint and/or muscle pain
•Mood swings
*G.I
• Anorexia
• Nausea, vomiting
• Abdominal pain
• Constipation or diarrhea
• Weight loss
• Salt craving
*Skin
• Vitiligo or
• Hyperpigmentation
*C.V
•Anemia
•Hypotension
•Hyponatremia
•Hyperkalemia
•Hypercalcemia
•Hypoglycemia
•Met Acidosis
•Hypovolemia
(May appear lethargic,
depressed & confused (even
psychotic)
Disorder
&
Pathophysiology
~ Addisons~
(Hypo-functioning Adrenal Gland)
*Primary causes*
-Adrenal gland hypofunction.
-Adrenal cortex production of
steroid hormone may
decrease as a result of
inadequate secretion of
adrenocorticotropic hormone
(ACTH).
-Direct problems of adrenal
gland tissue.
*Secondary Causes*
-Abruptly stopping long term
corticosteroids
Risk
Factors
~Primary~(Glandular problem)
• Autoimmune disease
• Tuberculosis
• Metastatic cancer
• HIV-III (AIDS)
• Hemorrhage
• Gram-negative sepsis
• Adrenalectomy
• Abdominal radiation therapy
• Drugs (mitotane) and toxins
~Secondary~
• Pituitary tumors
• Postpartum pituitary necrosis
• Hypophysectomy
• High-dose pituitary or wholebrain radiation
• Cessation of long-term
corticosteroid drug therapy
Radiation to Abd. or Head
Labs & Diagnostics
Labs:↓Glucose, Sodium, Cortisol & Aldosterone ↓
↑Potassium, Calcium, Hct & BUN↑
Diagnostic- ACTH stimulation (Definitive)
Shows cause of Pituitary problem & adrenal gland
atrophy.
MRI & CT scan
Treatment & Medications
Hormone Replacement
Hyperkalemia Management
Hypoglycemia Management
Prednisone
Hydrocortisone ( Glucocorticoid deficiency)
Fludrocortisone (Mineralocorticoid deficiency)
Dextrose IVP (↓ Glucose below 50-40)
Glucagon (↓ Glucose levels)
Nursing Interventions & Patient Education
N.I:
•Assessing V/S & cardiac function is PRIORTY
•Assess orientation to person, place, and time
•Promoting fluid balance
•Monitoring for fluid deficit
•Preventing hypoglycemia
• Assess vital signs every 1 to 4 hours
•Weigh the patient daily and record intake and output
•Monitor laboratory values to identify hemoconcentration
• Give glucose when Blood sugar drops below 70.