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S/S of Adrenal Hyperplasia
Visualization of genitalia during infancy.
Males- breast tissue, less to no facial hair
Females-facial hair, deep voice, masculine build, baldness, deposition of proteins in the skin
Visual di...
S/S of Adrenal Hyperplasia
Visualization of genitalia during infancy.
Males- breast tissue, less to no facial hair
Females-facial hair, deep voice, masculine build, baldness, deposition of proteins in the
skin
Visual disturbances if pituitary tumor is on the optic nerve.
What is adrenal hyperplasia?
A genetic defect that results in a lack of cortisol
What medications are used to treat Adrenal Hyperplasia?
Corticosteriods (Glucocticoids, Predisone)
What are side effects from corticosteriods use?
At increase risk for developing infections, brittle bones, thinning of the skin, moon face
and humpback. Muscle wasting, increase BP, thrombophleitis, thromboembolism,
accelerated atherosclerosis, glaucoma, corneal lesions, sleep disturbances, mental
changes.
Care plan for Cushing's Disease
Decrease injury risk
Decrease infection risk
Promote skin integrity
Promote positive body image
Nutrition needs for Cushing's Patients
Foods need to be high in potassium calcium and protein, low in sodium, low in sugar,
carbohydrates.
Priority Assessment for Cushing's Disease
Infection (fever and increase WBC-Leukocytosis), restlessness, N/V, and low BP.
When should you call a physician about a cushings patient?
Neuro s/s
Restlessness
When would you not call the doctor for a cushings patient?
When they have high BP
Highest risk for Cushing's disease?
20-40 year old women, long term steroid users
Complications s/s of post-op transsphenoidal hypophysectomy
Clear drainage on nasal drip pad, pink tinged fluid w/ halo, salty taste in back of throat
leukocytosis (increase WBC), urine output 800 ml/hr, visual disturbances, post-op
meningitis, pneumocephalus (air in the intracranial cavity).
Priority Assessment for Addison's Disease
, Heart rate due to dysrhythmias from the increase potassium in the body
What needs to be monitored before, during, and after a transsphenodial
hypophysectomy?
Blood glucose due to possible causing DI after procedure.
Addison's Disease Medication's
Hydrocortisone (Solu-Cortef), 5% Dextrose in normal saline, vasopressors may be
required if hypotension persists, an antibiotics.
Clinical Manifestations for Addison's Disease
Thin, dark, low NP, N/V
Low sodium, high potassium, low blood pressure, low glucose, high WBC, muscle
weakness, anorexia, GI symptoms, fatigue, emaciation, dark pigmentation of the
mucous membrane and skin, depression, confusion
Chronic- severe dehydration.
S/s of Addison's crisis?
N/V
Low BP
Neuro changes
Mimics the flu
Teaching plan for Addison's Disease
Need a diet high in carb, high in protein, and high in salt.
Avoid heat and stress at all cost. Going to be on lifelong steriod use. Need to know
about emergency steriod kit (100mg of hydrocortisone or 4mg dexamethasone and
0.9% sterile saline)
Wear ID bracelet. Call MD before going to the ER
Diabetes Insipidus Medication
Desmopressin (DDAVP)- watch on patients with coronary disease AND increase in
urine specific gravity.
Chlorpropamide (Diabines) and Thiazide Diuretics- watch for high BS.
Diabetes Insipidus S/S
Polydipsia (excessive thirst), oliguria, highly diluted urine, polyphagia (eating a lot), high
HR, high NA, if after surgery will see pink halos on drip pad.
Diabetes Insipidus Patho
Disorder of the posterior gland that results in an ADH deficiency. Secondary to head
trauma, brain tumor, or surgical ablation or irradiation of the pituitary gland, infection of
the CNS or with tumors.
Teaching plan for DI
Knowing the s/s of hyponatremia (CNS dysfunction, malaise/weakness, anorexia, N/V,
headache, confusion, leathargy, sz, coma, and cerebral hemiation due to brain swelling
or edema)
Priority Assessment for SIADH
Excessive fluid volume (crackles in the lungs)
SIADH Patho (S for swimming in fluid)
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