Addison’s Pathophysiology NR283 Professor Mkhani 01/25/2018 Introduction of

 

 

 

 

 

 

 

 

Addison’s Disease

Ricki Saroussi

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Chamberlain College of Nursing

Pathophysiology NR283

Professor Mkhani

01/25/2018

 

 

 

 

 

 

 

 

 

Introduction
of Disease

            According to the Health Library:
Evidence-Based information and according to the CINAHL Nursing Guide Addison’s
disease affects the adrenal glands and is a rare disorder. The adrenal glands
do not make sufficient glucocorticoids and mineralocorticoids, aldosterone and
cortisol and the treatment includes hormone medication. (DM, 2016)
(Lydia M. Uribe, 2017)

Pulse Clinical article about how not to
miss Addison’s disease states that Addison’s disease affects one in 10,000 and
it is an autoimmune disease with increasing incidences in western societies. Can
occur in any age and common with diseases such as type 1 diabetes and asthma. (Dr. Trevor Howlett, 2009)

Etiology

            Addison’s disease also known as AD, may
be by congenital developmental defects such as familial glucocorticoid
deficiency syndrome, adrenal destruction (secondary reaction to autoimmune disorder),
steroid synthesis. (Lydia M. Uribe, 2017) Addison’s
disease is caused by an autoimmune problem that destroys the adrenal glands and
according to CINAHL Nursing Guide CMV, AIDS, cancer, adrenal hemorrhage and
infraction, shock, fungal infection, radiation therapy and more can cause
Addison’s disease, but the most common cause in the world is Tuberculosis. (Dr. Trevor Howlett, 2009) Addison’s
disease affects more women than men, in all ages and risk factors include
consistent steroid use and immediate discontinuance, an endocrine disorder or a
family history of Addison’s disease. (Lydia M. Uribe, 2017)

 

 

Pathophysiological
Process

Because of adrenal dysfunction there is a
cortisol imbalance and the immune system and metabolism are affected. Because
of DHEA imbalance the secretion of testosterone and estrogen is affected and
because of aldosterone imbalances the water and electrolyte balance is
affected. ACTH is secreted in order to stimulate the adrenal glands but there
is loss of negative feedback and the adrenal glands are not able to function
properly. (Dr. Trevor Howlett, 2009)

Clinical
Manifestations and Complications

Signs and symptoms appear only after
ninety percent of the adrenal cortex is destroyed and they are sudden and can
be confused with other conditions because they are very common in many other
conditions – fever, fatigue, constipation, diarrhea, nausea, vomiting,
anorexia, dehydration, cold intolerance, dizziness, myalgia, abdominal pain, hyperpigmentation
(creases, elbows, perianal, etc.), vitiligo, postural hypertension, headache,
confusion and anxiety, depression and irritability and can also be confused
with autoimmune diseases. (Lydia M. Uribe, 2017)

Diagnosis

According to CINAHL Nursing Guide
laboratory tests will check levels of morning plasma levels of cortisol will be
low, and low serum cortisol levels indicate adrenal insufficiency after ACTH
will be administered. Morning plasma ACTH levels will be high; twenty-four hour
urine cortisol level will be low. Complete blood count will show anemia, neutropenia,
lymphocytosis and eosinophilia and a complete metabolic panel will indicate decreased
sodium and chloride and elevated potassium, calcium and BUN and could show
acidosis. Fasting b lood glucose will be low and xray may show a small heart.
Abdominal CT scan or MRI will have small adrenal that indicate the autoimmune
disease or infiltrative or hemorrhage cause in case the adrenals are enlarged.

            Annales De Biologe Clinique found in
their research that treatment that will normalize sodium concentration and will
replace the corticosteroids and will be able to allow Addison’s disease patient
to reach the same life expectancy as the normal population. (Hadrien Maguet, 2016)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Works Cited
DM, N. (2016,
May ). Discharge Instructions for Addison’s Disease . (Carmichael, Ed.) Health
Library: Evidence Based Practice Information EBSCO .
Dr. Trevor Howlett, S. P. (2009, April 29). How Not To Miss
Adisson’s Disease . Pulse Clinical .
Hadrien Maguet, A. C. (2016, january 23). An Addison’s
disease revealed with a serious hyponatremia . Biologie au quotidien .
Lydia M. Uribe, A. L. (2017, September 29). Addison’s
Disease. CINAHL Nursing Guide .