ADDISONIAN CRISIS

DISEASE: ADDISONIAN CRISIS – a life threatening disorder caused by acute adrenal insufficiency. Crisis precipitated by stress, infection, trauma or surgery. It can cause hyponatremia, hyperkalemia, hypoglycemia and shock.

SIGNS & SYMPTOMS: Severe headache, severe abdominal, leg and lower back pain, Generalized weakness, Irritability and confusion, Severe hypotension, Shock.

PATIENT TEACHINGS: Maintain bed rest and provide a quiet environment.

 TREATMENTS: Prepare to administer glucocorticoids intravenously as prescribed; hydrocortisone sodium succinate(Solu-Cortef) usually is prescribed initially. Following resolution of the crisis, administer glucocorticoid and mineralocorticoid orally as prescribed. Monitor vital signs, particularly BP. Monitor neurological status, noting irritability and confusion. Monitor I & O. Monitor lab values, particularly sodium, potassium and blood glucose. Administer IV fluids as prescribed to restore electrolyte balance. Protect the client from infection.

DIETS AND DRUGS: High protein, carbohydrate, & sodium intake. Dexamethasone, Hydrocortisone and Fludrocortisone.