Significance to Nursing

Legal and Ethical Responsibilities: Educate patient and family on the importance of taking medications as prescribed. It is a lifelong therapy. Educate patient about dietary considerations; limit salt intake and avoid fasting. Promote autonomy, beneficence, and nonmaleficence. Encourage normal, active lifestyles. Increasing Incidences: Increase nurses knowledge of signs and symptoms. Facilitate communication between other nurses, endocrinologists, primary care providers, and family members. Increased incidence of diabetics within the population.

Nursing Diagnoses
1. Disturbed body image r/t increased skin pigmentation aeb dark patches of bronze skin covering the body. 2. Activity intolerance r/t weakness and fatigue. 3. Deficient fluid volume r/t failure of regulatory mechanisms aeb hypotension, nausea, and vomiting. Outcomes: 1. Demonstrate adaptation to changes in physical appearance or body function. 2. Demonstrate increased tolerance to activity. 3. Explain measures that can be taken to treat or prevent fluid volume loss.
4

Addisons Disease
Emily Vance Nursing 300

References 1. Ficorelli, C.T. (2013). Addison disease: The importance of early diagnosis. Nursing made Incredibly Easy. 11(2), p. 11-15. 2. U.S. National Library of Medicine. (2011). Addisions disease. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH000 1416/ 3. Luken, K.K. (1999). Clinical manifestations and management of addisons disease. Journal of the American Academy of Nurse Practitioners. 11(4), p. 151-154. 4. . Ladwig, G., & Ackley, B. (2011). Mosb'ys guide to nursing diagnosis. (3rd ed.). Maryland Heights, MS: Mosby Elsevier.

Addisons Disease
What What

is Addisons Disease?

A disorder that occurs when the adrenal glands are damaged and cant produce enough of the hormone cortisol and often the hormone aldosterone. Addison disease is also called adrenal insufficiency. 1 Etiology: caused by a result of damage to the adrenal cortex. This damage can be caused by trauma, tumors, or certain infections (HIV, Tb).
2

Primary Adrenal Insufficiency: Dysfunction or destruction of the adrenal cortex. Secondary Adrenal Insufficiency: Absence or lack of ACTH. 3

Lifespan & Cultural Considerations

If treated properly people with Addisons Disease can live a long normal life. Occurs in all ethnic groups Can be seen in all ages More common in females and children Onset in adults is usually between ages of 30 and 60 years old
2, 3

Clinical Manifestations & Potential Complications

Signs and Symptoms: Hyperpigmentation bronze skin color (primary only) Mouth lesions Amenorrhea Salt craving Weakness and fatigue Orthostatic hypotension 2, 3 Nausea and vomiting Weight loss Potential Complications: Diabetes Sexual dysfunction Hypoglycemia Addisonian Crisis, which can2cause: Stroke MI

Risk Factors: Family history of Addisons Disease Tuberculosis Cancer Trauma to adrenal cortex Having other autoimmune diseases
2

Incidence: Addisons disease is very rare. In 1999, the incidence was 6 cases per 1 million adults per year.
3

Pathophysiology: results from the progressive destruction of the adrenal cortex. Clinical signs and symptoms do not appear until at least 90% of the adrenal cortex is destroyed. It is caused by either primary or secondary adrenal insufficiency. 3