ADDISONS DISEASE

DESCRIPTION

Addison’s disease is a chronic condition in which your adrenal glands don’t produce enough of the
hormone’s cortisol and aldosterone.

Cortisol is a hormone that helps your body respond to stress, including the stress of illness, injury or
surgery. It also helps maintain your blood pressure, heart function, immune system and blood glucose
(sugar) levels. Cortisol is essential for life.

Aldosterone is a hormone that affects the balance of sodium (salt) and potassium in your blood. This in
turn controls the amount of fluid your kidneys remove as urine (pee), which affects blood volume and
blood pressure.

Addison’s disease is also called primary adrenal insufficiency. A related disorder, secondary adrenal
insufficiency, happens when your pituitary gland doesn’t release enough adrenocorticotropic hormone
(ACTH), which activates your adrenal glands to produce cortisol.

ETIOLOGY

Etiology includes the following:

1. Autoimmune response
2. Inadequate secretion of adrenal hormone
3. Infection of adrenal gland
4. Atrophy of the adrenal cortex

MANIFESTATIONS

lethargy (abnormal drowsiness or tiredness) muscle weakness. low mood (mild depression) or irritability.
loss of appetite and unintentional weight loss.

PATHOPHYSIOLOGIC PROCESS
NURSING INTERVENTIONS

Monitor weight

Lack of appetite due to decreased levels of cortisol may cause significant decrease in body weight

Encourage oral fluids

Deficiency of cortisol may lead to anorexia and impaired GI function. Encourage oral fluids to help
maintain adequate sodium levels and avoid dehydration.

Minimize stress and assist with activities / provide rest periods

Simple stress and overexertion can cause a life-threatening Addisonian crisis due to lack of
corticosteroids that help the body react to and manage stress.

Monitor nutrition

Aldosterone deficiency causes the kidneys to excrete sodium which may result in salt cravings.
Encourage patients to increase salt intake and supplements as necessary to prevent hyponatremia.
Encourage patients to eat high protein / low carb snacks and meals as tolerated followed by rest periods
to prevent fatigue due to hypoglycemia and to facilitate digestion.

I & O – monitor intake and output

Monitor urine for decreased output (desired >30ml/hr), concentration and color which may be darker

Assess vitals; temperature, blood pressure and heart rate – watching for orthostatic changes and
hyperpyrexia

A decrease of 15 mm Hg or more and increase in heart rate (normal <100bpm) may indicate reduced