Addisonian Crisis

Question 1

Patho

Answer 1

adrenal gland damaged

ACTH and melanocyte stimulating hormone are secreted in large amounts

Question 2

are symptoms seen early on in the disease?

Answer 2

No, symptoms shown when 90% nonfunctional

Question 3

Hypoaldosteronism

Answer 3

Problems with sodium and water retention

Hypotension
Decreased vascular tone, CO, circulating blood volume
Salt craving – decreased sodium, dehydration
Hyper kalemia

Question 4

Hypo cortisol ism

Answer 4

hypoglycemia
Weakness, fatigue
Unsuppressed AC TH – hyper pigmentation

Question 5

pharm

Answer 5

lifelong steroid treatment
HydroCortizone **

Dosing mimics normal release of hormones
Never abruptly stop
Increase dose with stress
Emergency supply – IM/PO

Question 6

what should be done to the dosing in times of infection, trauma, surgery?

Answer 6

3x3 rule

Question 7

Addisonian crisis complication

Answer 7

Sudden insufficiency of serum corticosteroids

Due to loss of adrenal gland
Due to increased stress in chronic condition
Due to sudden cessation of drug therapy

Question 8

s/sx crisis

Answer 8

sudden pain in lower back, abdomen, legs
severe vomiting, diarrhea
Dehydration
Hypotension
CNS – LOC, confusion, slurred speech
hyper kalemia
Hyponatremia

Question 9

initial treatment for crisis

Answer 9

IV. Hydro Cortizone – initial Bolus
saline, dextrose

Question 10

when can the patient be transitioned to PO meds and fluids?

Answer 10

When stable and can tolerate
Taper doses