Endocrine System - Adrenal Gland Disorders

Front 1

Adrenal Gland Disorders
(Adrenal Cortex)

Back 1

1. Addison's disease
2. Cushing's disease
3. Conn's syndrome

Front 2

Adrenal Gland Disorders
(Adrenal Medulla)

Back 2

1. Pheochromocytoma

Front 3

Addison's Disease

Back 3

1. Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids)
2. Can be primary or secondary
3. The condition is FATAL IF LEFT UNTREATED

Front 4

Assessment for Addison's Disease

Back 4

1. Lethargy, fatigue, & muscle weakness
2. GI disturbances
3. Wt. loss
4. Menstral changes in women; impotence in men
5. Hypoglycemia, Hyponatremia
6. Hyperkalemia, Hypercalcemia
7.Postural Hypotension
8. Hyperpigmentation of skin (bronzed) w/primary disease

Front 5

Interventions for Addison's Disease

Back 5

Monitor the following:
1. Vital Signs (BP, blood glucose, K+, Na+, Ca+
2. Administer glucocorticoid or mineralocorticoid medications as prescribed
3. Observe for addison crisis caused by stress, infection, trauma, or surgery

Front 6

Patient Education for Addison's Disease

Back 6

1. Avoid individuals with an infection
2. Diet: High protein & carbohydrate and normal Na+ intake
3. Avoid strenuous exercise and stressful situations
4. Need for lifelong glucocorticoid therapy
5. Avoidt OTC medicaitons
6. Wear a Medical-Alert Bracelet
7. S/S of complications such as underreplacement and overreplacement of hormones

Front 7

Addison's Crisis
(Description)

Back 7

1. A life-threatening disorder caused by acute adrenal insufficiency
2. Precipiatate by stress, infection, trauma, surgery, or abrupt withdrawl of exogenous corticosteroid use
3. Can cause hyponatremia, hyperkalemia, hypoglycemia, and shock

Front 8

Assessment for Addison's Crisis

Back 8

1. Severe headache
2. Severe abdominal, leg, and lower back pain
3. Generalized weakness
4. Irritability and confusion
5. Severe Hypotension
6. Shock

Front 9

Interventions for Addison's Crisis

Back 9

1. Prepare to adminster glucocorticoids intravenously as prescribed
2. Following resolution of the crisis, administer glucocorticoid and mineralocorticoid orally as prescribed
3. Monitor vital signs, particulary BP
4. Monitor neurological status, noting irritability and confusion
5. Monitor intake and output
6. Monitory lab values of Na+, K+, and blood glucose level
7. Administer IV fluids as prescribed to restore electrolyte balance

Front 10

Cushing's Disease

Back 10

A metabolic disorder characterized by abnormally increased secretion of cortisol, caused by increased amounts of ACTH secreted by the pituitary gland

Front 11

Cushing's Disease and Cushing's Syndrome

Back 11

Characterized by a hypersecretion of glucocorticoids from the adrenal cortex.

Front 12

Cushing's Syndrome

Back 12

A metabolic disorder resulting from the chronic and excessive production of cortisol, by the adrenal cortex or by the administrationof glucocorticoids in large doses for several weeks or longer .

Front 13

Assessment of Cushing's Disease and Syndrome

Back 13

1. Generalized muscle wasting & weakness
2. MOON FACE
3. BUFFALO HUMP
4. Truncal obesity w/thin extremities, supra clavicular fat pads; wt. gain
5. HIRSUTISM (masculine characteristics in female)
6. Hyperlycemia, Hypernatremia
7. Hypokalemia, Hypocalcemia
8. Hypertension
9. Fragile skin that easily bruises
10. Reddish-purple striae on the abdomen and upper thighs

Front 14

Interventions for Cushing's Disease and Syndrome

Back 14

1. Provide meticulous skin care
2. Administer chemotherapeutic agents as prescribed for inoperable adrenal tumors
3. Prepare the client for radiation as prescribed if the condition results from a pituitary adenoma

Front 15

Conn's Syndrome

Back 15

Hypersecretion of mineralocorticoids (aldosterone) from the adrenal cortex of the adrenal gland

** Most commonly caused by an adenoma **

Front 16

Pheochromocytoma

Back 16

1. Catecholamine-producing tumor usually found in the adrenal medulla, but extra-adrenal locations include the chest, bladder, abdomen, and brain; typically is a benign tumor but can be malignant
2. Excessive amounts of epinephrine and norepinephrine are secreted
3. 24 hr urine collection looking for vanilylmandelic acid (VMA)
4. Surgical removal of the adrenal gland is the primary Tx

Front 17

Adrenalectomy

Back 17

Surgical removal of an adrenal gland.
1. Lifelong glucocorticoid and mineralocorticoid replacement are necessary with bilateral adrenalectomy
2. Temorary glucocorticoid replacement, usually up to 2 yrs, is necessary after a unilateral adrenalectomy
3. Catecholamine levels drop as a result of surgery, which can result in cardiovascular collapse, hypotension, and shock, and the client needs to be monitored closely.
4. Hemorrhage also can occur b/c of the high vascularity of the adrenal glands

Front 18

Adrenalectomy
(Preoperative Interventions)

Back 18

1. Monitor for hyperglycemia
2. Assess for dyrhymias
3. Monitor electrolyte levels and correct electrolyte imbalances

Front 19

Adrenalectomy
(Postoperative Interventions)

Back 19

1. Monitor vital signs
2. Monitor intake and output; if the urinary output is lower than 30 mL/hr, notify the physician, b/c this may indicate renal failureand impending shock
3. Monitor for signs of hemorrhage and shock, particularly during the first 24 - 48 hrs.
4. Administer glucocorticoids and mineralocorticoids as prescribed
5. Instruct the client in the importance of hormone replacement therapy following surgery