Chapter 17 ( Adrenal Insufficiency and Crisis) Flashcards Preview

Medical Emergencies > Chapter 17 ( Adrenal Insufficiency and Crisis) > Flashcards

Flashcards in Chapter 17 ( Adrenal Insufficiency and Crisis) Deck (15)
Loading flashcards...
1

adrenal gland

- exocrine glands
- on top of both kidney
- consist of medulla and cortex
- medulla produces epinephrine and norepinephrine

2

what does the cortex produces?

- cortisone
1. mobilizes nutrients, modifies body's response to inflammation, stimulates liver to raise blood sugar, and controls water in body.
- aldosterone
1. regulates salt and water levels BP

3

two categories of adrenal insufficiency are?

1. primary or addison's disease
2. secondary

4

primary adrenal insufficiency

- destruction of adrenal cortex
- etiologies: autoimmune, TB, adrenal, hemorrhage, adrenal metastases, AIDS
- 93-140 million individuals
- 4th decade of life
- women more than men

5

secondary adrenal insufficiency

- 150-280 million individuals
- 6th decade of life
- women more than men

6

Adrenal crisis (body severely lacking cortisol) 1/2 reason

1. individual not yet diagnosed- needs cortisol to maintain carbohydrate and protein metabolism
- often happens as this condition mimics other illnesses.

7

Adrenal crisis (body severely lacking cortisol) 2/2 reason

2. patient with adrenal insufficiency in a stressful situation and requires additional cortisol
- often occurs in individuals on long time steroid therapy

8

signs and symptoms of adrenal crisis

- fatigue
- lethargy
- muscle weakness
- headache

9

signs and symptoms of adrenal crisis

- confusion
- fever
- nausea
- vomiting

10

signs and symptoms of adrenal crisis

- abdominal pain
- hypotension
- tachycardia
- diaphoresis
- dehydration

11

treatment of adrenal crisis

- contact EMS
- stabilize until EMS arrives
- maintain airway
- monitor vital signs

12

treatment of adrenal crisis

- admister O2 4-6L/ min if needed
- IV fluids need and glucocoticoids

13

prevention of adrenal crisis

- occur up to 12 months after patient is removed from exogenous corticosteroids
- stressful situations can trigger crisis (dental appt.)
- may need to take steroids when stress anticipated
- need to consult MD

14

rules of prevention of adrenal crisis for taking steroids (1/2 rules)

1. OLD REGIMEN
- 20 mg cortisone (or equivalent) for 2 weeks within 2 years of dental treatment at risk for adrenal suppression

15

rules of prevention of adrenal crisis for taking steroids (2/2 rules)

1. NEW REGIMEN
- most patients taking steroids do not need additional steroids for dental treatment unless severe phobics or major surgical procedure (additional 5-10 mg hydrocortisone if stressful)