stimulates reabsorption of sodium, sustaining blood volume what is the function of aldosterone?
and pressure in the face of salt deprivation or extracellular
fluid depletion
Catecholamines (epinephrine and norepinephrine) what hormone is secreted from the adrenal medulla?
increases what happens to blood sugar when a patient takes a steroid?
also known as acute adrenal insufficiency what is an addisonian crisis?
a life-threatening event in which the need for cortisol and
aldosterone is greater than the body's supply (adrenal
gland hypofunction)
surgery what are causes of an addisonian crisis?
trauma
severe infection
also known as adrenal insufficiency what is Addison's disease?
chronic deficiency of cortisol and aldosterone (adrenal
gland hypofunction)
primary: autoimmune disease (tuberculosis back in the day) what are the most common primary and secondary causes of Addison's disease?
secondary: cessation of long-term corticosteroid drug
therapy
fluid deficit and hypoglycemia what are the two main concerns of the nurse when caring for a patient with Addison's
disease and/or addisonian crisis?
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low sodium expected lab values for adrenal gland hypofunction
high potassium
normal to low glucose
high calcium
high bicarb
high BUN
low cortisol
high sodium expected lab values for adrenal gland hyperfunction
low potassium
normal to high glucose
low calcium
low bicarb
normal BUN
high cortisol
10-20 mg/dL normal BUN
23-30 mEq/L normal bicarbonate level
9-10.5 mg/dL normal calcium level
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-administer prednisone (glucocorticoid): if in crisis, give what is are interventions for Addison's disease and addisonian crisis?
solumedrol (IV prednisone)
-administer fludrocortisone/Florinef (mineralocorticoid):
increases reabsorption of sodium and loss of potassium
-skull x-ray: looking for tumor on pituitary gland
-educate patient on wearing medical alert bracelet
-anger side effects of prednisone
-decreased immune response
-decreased wound healing
-insomnia
-increases HR
taking supplemental steroids leads to suppression of why must nurses educate their patients on not stopping steroid use abruptly?
normal steroid production, so tapering off allows adrenal
glands time to return to their normal patterns of secretion
-hypovolemia signs and symptoms of abrupt steroid cessation
-hypotension
-vomiting/dehydration
also known as hypercortisolism what is Cushing disease?
excess secretion of cortisol from adrenal cortex (adrenal
gland hyperfunction)
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