Addison’s and Cushing’s Management
A 58-year-old woman presents with fatigue, anorexia, weight loss, diarrhea. She is afebrile, denies any abdominal pain, rectal bleeding and had a normal colonoscopy 8 months ago. Her BP today is 90/62. When you ask about her family’s health history it is negative except, she reports her mother had Addison’s disease, but she never understood what it meant but and she wonders if she could have it as well. Based on the information provided above, you suspect Addison’s disease.
- How would you explain the pathophysiology of Addison’s disease in terms the patient can understand?,
- Discuss the diagnostic tests needed to diagnose Addison’s and Cushing’s disease.,
- Discuss the initial management of Addison’s disease and Cushing’s disease.,
- Discuss 2 drugs that may be included in the management of Addison’s disease.,
- Discuss 2 APRN roles you would use in your treatment of a patient with Addison’s and/or Cushing’s disease. ,
Explaining the Pathophysiology of Addison’s Disease in Simple Terms
Addison’s disease is a condition where the adrenal glands, which are small glands located on top of the kidneys, don’t produce enough of certain important hormones. These hormones help control things like blood pressure, energy levels, and how your body responds to stress. When these hormone levels are too low, it can cause symptoms like fatigue, weight loss, low blood pressure, and feeling generally unwell. This might be why you’re feeling tired and not eating as much. Since your mother had Addison’s, it’s possible you could have it too because it sometimes runs in families.
Diagnostic Tests for Addison’s and Cushing’s Disease
To diagnose Addison’s disease, the following tests are commonly done:
- ACTH stimulation test: This test measures how well your adrenal glands respond to a hormone called ACTH. If your adrenal glands don’t produce enough cortisol in response, it could indicate Addison’s disease.
- Blood tests: These check for low levels of cortisol and high levels of ACTH, which can point to Addison’s. They also look at electrolyte levels, such as sodium and potassium, as imbalances are common in Addison’s disease.
