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DEFINITION

Addisons disease is

a rare, chronic endocrine

disorder where the adrenal

glands do not producesufficient steroid

hormones.

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1 in 100,000

Any Age, Gender,

Or Ethnicity

More common in

women

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ETIOLOGY

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ETIOLOGY

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Other causes

Tuberculosis

Surgical removal of both adrenal

glands

Inadequate secretion of ACTH

Therapeutic use of corticosteroids

Sudden cessation of hormone

therapy.

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PATHOPHYSIOLOGYDue to any etiological factors

Hypofunction of adrenal cortex

Lack of pituatory ACTH secretion

Decrease secretion of the adrenal corticosteriods.

Destruction of the adrenal tissue

Adissonsdisease

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PATHOPHYSIOLOGY

Due to any etiological factors

Insufficiency of adrenal corticoids

Loss of mineralocorticoids and glucocorticoids

H2O Excretion Metabolic Disturbances

Hyponatremia Hypoglycemia

Hypovolemia Secretion of ACTH

Hypotension Adrenal crisis

cardiac output

Shock & death

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Hypoglycemia

Muscle weakness

dehydration

Skin hyper pigmentation

Hypotension

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Hyponatremia

Hypovolemia

Hyperkalemia

Psychological disturbance

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Adrenal crisisIt is usually seen in an

undiagnosed person who undergoesa major stressor, in a person who

has abrupt withdrawl of therapeutic

glucocorticoids, or in a person with

a poorly controlled condition who

enters a stressful situation.

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BLOOD

INVESTIGATIONS

ACTH stimulation test

Plasma ACTH

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BLOOD

CHEMISTRY

Hyponatremia(5mEq/L)

Low fasting blood

glucose level

(20mg/100mL )Decreased serum

cortisol level

(

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HEMATOLOGYLymphocytosis

Increasedeosinophils

Hemoconcent

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Urine tests

Urine 17-

ketosteroids

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Other tests

Electrogram

Abdominal x-ray

Abdominal CT scan

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Treatment of cause

Administering fluids

Administration of glucose

Recumbent position

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Glucocorticoids

Mineralocorticoids

Administration of vasopressorsAntibiotics

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Nursing Diagnoses

Deficient Fluid Volume related torenal losses of sodium and water

Risk for Injury related to

ineffective stress responseActivity Intolerance related to

decreased cortisol production andfatigue

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Nursing Management

Nursing assessment

Nursing diagnoses

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Nursing Diagnoses

Deficient Fluid Volume related to renal losses

of sodium and water

Risk for Injury related to ineffective stress

response

Activity Intolerance related to decreased

cortisol production and fatigue

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Health Education

Instruct about the necessity

for long-term therapyInform that therapy must be

continued throughout his lifespan.

Instructed to never stop steroid

medications

Always carry identification card

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