What is Addison’s disease?
Addison’s disease is a chronic form of adrenal insufficiency resulting from autoimmune processes that damage the adrenal glands. Inadequate production of cortisol, aldosterone, and other adrenal hormones leads to a broad range of non-specific symptoms.
What are the symptoms of Addison’s disease?
The symptoms of Addison’s disease are non-specific and may be overlooked or mistaken for other conditions. They can include:
- Darkening of the skin
- Weight loss
- Abdominal pain
- Vitiligo
- Muscle weakness
- Dehydration
- Tachycardia
- Hypotension
- Nausea
- Vomiting
- Diarrhea
How is Addison’s disease diagnosed?
Addison’s disease is diagnosed through diagnostic lab values, including plasma cortisol < 3 mcg/dL, ACTH > 200 pg/mL, and low or no cortisol response to ACTH stimulation test.
What is the treatment for Addison’s disease?
The treatment for Addison’s disease involves lifelong replacement of glucocorticoids and mineralocorticoids with careful monitoring to avoid complications of over- or under-treatment.
With proper hormone replacement therapy and regular monitoring, individuals with Addison’s disease can lead normal, active lives. They must, however, be aware of the risk of an Addisonian crisis.
What is the hypothalamic-pituitary-adrenal (HPA) axis?
The hypothalamic-pituitary-adrenal (HPA) axis regulates the body’s stress response. Under normal circumstances, activation of the hypothalamus secretes corticotropin-releasing factor (CRF) which triggers the anterior pituitary to produce the hormone adrenocorticotropic (ACTH), which then stimulates the adrenal glands to inhibit or release glucocorticoids as needed. This is a negative feedback process.
How does Addison’s disease affect electrolyte balance?
Addison’s disease leads to decreased production of aldosterone, causing imbalances such as hyperkalemia (high potassium) and hyponatremia (low sodium).
Nursing diagnoses for Addison’s disease
- Decreased activity tolerance: related to fatigue, weakness
- Disturbed body image: skin pigmentation changes
- Deficient knowledge: related to new diagnosis
- Risk for shock: related to adrenal insufficiency during periods of stress
- Risk for electrolyte imbalance: related to aldosterone deficiency
- Risk for impaired skin integrity: related to excessive skin pigmentation
