NURS 322 adrenal diseases notes

Adrenal Glands
Hypofunction Hyperfunction
Also known Addison’s disease Cushing’s syndrome (broad term for excess
as… production of CRH, ACTH, or glucocorticoids)

Cushing’s disease (if due to pituitary tumor)

Causes
1. Primary Destruction of adrenal glands Main cause is the long term use of
 Autoimmune** (most common) AKA idiopathic corticosteroids.
 chronic steroid use also a major cause
 infections, cancer, trauma, surgical removal of adrenal Rarely caused by increased cortisol production
glands secondary to hyperplasia of adrenal cortex.
 Tuberculosis and histoplasmosis most common infections

2. Secondary Decreased secretion of ACTH from anterior pituitary gland Pituitary tumor that produces ACTH which
stimulates adrenal cortex to increase hormone
secretion (even though it is producing normal
amounts).
Acute/Sever Addisonian (Adrenal crisis) -life-threatening emergency
e form of  Hypotension, N/V, signs of shock
condition  May have headache, abdominal pain & diarrhea, signs of
confusion
Assessment
/ diagnosis
1. Clinical  Weakness  Decrease of growth
Manifestation  Weight loss, fatigue  Central type obesity
s  Nausea, abdominal pain, gastroenteritis  Musculoskeletal changes (buffalo hump,,
 Emotional lability (irritability, depression, inability to kyphosis, backaches)
concentrate)  Glucose intolerance
 Hypoglycemia  "moon face"
 Hyperkalemia  May have increased oiliness of skin and
 Hyperpigmentation acne
 Loss of Na+ and water  dehydration and hypotension  Appearance of masculine traits in women
(hirsutism, breast atrophy, menses stops

, causing fertility issues
1