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Adrenal disorders -- Cloned from: Endocrine Disorders
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Adrenal
Glands



Adrenal glands consist of 2 parts the
cortex and medulla


Cortex



•outer covering secretes various types of
steroid hormones that regulate many vital functions (metabolism, supply quick
energy, maintain fluid and electrolyte balance and development of secondary sex
characteristics) Sex,
Salt, Sugar


Medulla



stimulates the sympathetic nervous system
and secretes epinephrine and norepinephrine and catecholamines- Fight or Flight


Adrenal
Disorders



•Cushing’s Syndrome
•Primary Aldosteronism
•Addison’s Disease
•Adrenal Neoplasms (Pheochromocytoma)


Addison’s
Disease



•Caused from destruction or degeneration
of adrenal cortex of unknown etiology, could be a pituitary problem in which
ACTH is not produced, tuberculosis, cancer, massive infections


S/S of Addison's Disease


  • fluid and electrolyte imbalances
  • hypoglycemia
  • hyponatremia
  • hyperkalemia
  • darkening of skin and mucous membranes as in a perpetual
    suntan (bronzed appearance)
  • abnormally low BP



Treatment for Addison's Disease



Supply needed hormones to restore normal
fluid and electrolyte balance (this is for the rest of their lives), high protein high sodium low potassium diet.


Nursing care for Addison's Disease


  • Treat dehydration
  • replace fluids
  • sodium replacing diet
  • restricted water intake
  • frequent small meals and snacks
  • monitor for dizziness and hypotension
  • protect from falls
  • I&O, monitor urine sp. gr, daily weights



Cushing’s
Syndrome


Also called hyperadrenalism-overproduction of hormones secreted by the adrenal cortex, can be caused from overuse of corticosteroids (athletes)or tumors of the pituitary


Signs and Symptoms of Cushing's syndrome


Rounded face (moon face), abdomen is heavy and hangs down,
arms and legs are thin, buffalo hump, weakness, soft bones, backache, edema,
urinary output↓, hypertension, wounds are slow-healing, bruises easily, striae
on abdomen, mood swings, irritable(aggressiveness) or euphoric, hypokalemic,
hypernatremic, hyperglycemic


Treatment of Cushing's Syndrome


Surgical removal of the adrenal gland, Supply
needed hormones to restore normal fluid and electrolyte balance (this is for the rest of their lives), high protein high sodium low potassium diet.


Nursing Care for Cushing's Syndrome



•symptomatic, protect patient from infections and injuries, protect skin integrity, promote good hygiene, monitor daily weights, check VS frequently, Monitor electrolytes and glucose levels


Primary
Aldosteronism



•Rare
•Excessive secretion of aldosterone
•S/S: hypertension, muscle weakness d/t low potassium levels and retained sodium
•Treatment: surgery to remove tumor or
remove entire adrenal gland


MAKE SURE TO LOOK AT TABLES 42-5 AND 42-6 FOR CORTICOSTERIODS DING DING DING