Medical-surgical Nursing Demystified

(Sean Pound) #1

(^348) Medical-Surgical Nursing Demystified



  • Weigh the patient daily using the same scale, at same time of day with similar
    clothing.

  • Monitor intake and output.


Addison’s Disease


WHAT WENT WRONG?


Addison’s disease is inadequate secretion of corticosteroids from the adrenal cortex,
resulting from damage to the adrenal cortex. Autoimmune destruction of the adrenal
gland and tuberculosis are two common causes of Addison’s disease. A patient can
experience Addisonian crisis when infection, surgery, or other stressful events results
in a decrease in the production of cortisol and aldosterone. Addisonian crisis is a
medical emergency.

PROGNOSIS


With ongoing treatment, patients can expect a normal life span.

HALLMARK SIGNS AND SYMPTOMS



  • Weakness due to insufficient cortisol

  • Weight loss due to insufficient cortisol

  • Orthostatic hypotension due to poor fluid status from aldosterone deficiency

  • Bronzing of the skin due to hyperpigmentation from the autoimmune disease


INTERPRETING TEST RESULTS



  • Increased BUN due to dehydration.

  • Increased serum potassium from changes in aldosterone secretion.

  • Decreased serum cortisol being secreted from the adrenal cortex.

  • Decreased serum glucose from decreased corticosteroids.

  • Positive 24-hour urine aldosterone level due to less aldosterone being secreted.


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