Exam 3: Addison's disease Questions with Correct Answers Rated A+

Reduced In Addison's disease, all three classes of adrenal corticosteroids are _________________ Autoimmune Up to 80% of Addison's disease cases in the US are caused by an ____________ response, which cause the adrenal cortex to be destroyed by antibodies Polyglandular Addison's disease can present along with other endocrine conditions, which is known as autoimmune ___________ syndrome Iatrogenic __________ Addison's disease may be due to adrenal hemorrhage, often related to anticoagulant therapy, chemotherapy, ketoconazole therapy for AIDS, or bilateral adrenalectomy 90% Clinical Manifestations Because manifestations do not tend to become evident until _____% of the adrenal cortex is destroyed, the disease is often advanced before it is diagnosed. -Anorexia -Nausea -Progressive weakness -Weight loss Clinical Manifestations What are four manifestations of Addison's disease? ACTH Clinical Manifestations Increased ________ causes the striking feature of a bronze-colored skin hyperpigmentation Addisonian Complications An _________ crisis if a life-threatening emergency caused by insufficient adrenocortical hormones or a sudden sharp decrease in these hormones. It can be triggered by: 1. Stress 2. Withdrawal of corticosteroid hormone therapy 3. Adrenal surgery 4. Sudden pituitary gland destruction Glucocorticoid Mineralocorticoid Complications During acute adrenal insufficiency, the patient experiences manifestations of ____________ and _____________ deficiencies, including hypotension, tachycardia, dehydration, hyponatremia, hyperkalemia, hypoglycemia, fever, weakness, and confusion ACTH Stimulation Test Diagnostic Studies This test is used to diagnose adrenal insufficiency. The patient is given IV injection of synthetic ACTH after obtaining a baseline. Cortisol and ACTH levels are rechecked after 30 and 60 minutes. The normal response is a rise in blood cortisol levels. People with Addison's have little or no cortisol levels Corticotropin-releasing hormone stimulation test Diagnostic Studies When the response to ACTH test is abnormal, this test is done. Patient is given an IV injection of synthetic CRH, and blood is taken after 30 and 60 minutes. Those with Addison's have high ACTH levels but no cortisol Hydrocortisone Interprofessional Care This is the most commonly used form of hormone therapy. It has both glucocorticoid and mineralocorticoid properties Addisonian Crisis Interprofessional Care Treatment for this is directed towards shock management and high-dose hydrocortisone replacement Fluid and Electrolyte Interprofessional Care When the patient with Addison's disease is hospitalized, nursing management focuses on monitoring the patient while correcting what imbalance? Glucocorticoids Interprofessional Care _____________ are usually given in divided doses, two thirds in the morning and one third in the afternoon Mineralocorticoids Interprofessional Care ______________ are given once daily, preferably in the morning Exogenous Interprofessional Care The patient with Addison's disease is unable to tolerate physical or emotional stress without additional _________ corticosteroids, so stress management is a priority 100 mg Interprofessional Care The patient should carry and emergency kit at all times with _____ mg of IM hydrocortisone, syringes, and instructions for use Nonreplacement Interprofessional Care When corticosteroids are used as __________ therapies, they are taken once daily or once every other day Cortisol Interprofessional Care Because exogenous corticosteroid administration may suppress exogenous ACTH and therefore endogenous _______, teach the patient the dangers of abruptly stopping corticosteroid therapy