Cushing's vs. Addison's PDF

Cushings Disease: -Disorder of the adrenal cortex -Due to long term steroid use -ex: COPD patients -Patho: overuse of cortisol/steroid meds causing an increase in cortisol, aldosterone and antigens -Risk Factors: women, TUMOR IN ADRENAL GLAND, overuse of cortisol...

Cushings Disease: -Disorder of the adrenal cortex -Due to long term steroid use -ex: COPD patients -Patho: overuse of cortisol/steroid meds causing an increase in cortisol, aldosterone and antigens -Risk Factors: women, TUMOR IN ADRENAL GLAND, overuse of cortisol meds -Signs and Symptoms: -Cushion: Obese, moon face, buffalo hump -Usual hair growth: hirsuitism -Skin: purple striae, butterfly mark -High sugar, B/P, and weight -V/S & Labs: CUSHINGS IS PUSHING LEVELS UP -B/P: high (due to high cortisol) -Fluid Volume: high -Weight: high -Blood sugar: high -Sodium: high -Potassium: low -Calcium: low: WATCH FOR OSTEOPOROSIS *FALL RISK* -WBC’s: high -BUN: high -Complications: -Addisonians: due to sudden stop in steroid use -WATCH FOR SUDDEN LOW B/P -Treat by hydrocortisone first then fluids (D5NS) -Osteoporosis -Hypertensive crisis -Treatment: -Bisphosphonates -Replace steroids: to prevent addisonians -Adenalectomy: replace hormones/steroids -Nursing Considerations: -Taper off steroids -Watch for mental changes and body image issues -Diet: low carb/sodium, high potassium/calcium -Monitor glucose Addison’s Disease: -Absent steroids (so we need to add some) -Patho: removal of adrenal glands, TB, cancer, pituitary tumor -Signs and Symptoms: -BRONZED SKIN -Skinny -Salt craving -Hair loss -Amenorrhea -V/S & Labs: -HyperK -Decreased B/P -Decreased glucose -HyperCalcemia -Hyponatremia -Low energy -Low cortisol and aldosterone -Increase BUN -Complications: -Addisonian crisis due to sudden stop in steroid use -WATCH FOR SUDDEN LOW B/P -Treat by hydrocortisone first then fluids (D5NS) -Treatment: -LIFELONG TREATMENT -Glucocorticoid/mineralcorticoid IV: GIVE SECOND -Hydrocortisone shot: GIVE FIRST -Salt -Vasopressin -Nursing Considerations: -Monitor fluid balances -Monitor for seizures -Medical alert bracelet -Report signs of infection -Increase cortisol during high stress times -Tele