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Addison Cushing

The document provides a review of Addison's disease and Cushing's syndrome/disease for nursing students preparing for the NCLEX exam. It covers the signs and symptoms, causes, and nursing management of each condition. Addison's disease results from low production of cortisol and aldosterone hormones, causing low blood sugar and sodium levels. Cushing's syndrome/disease occurs when there is high cortisol levels due to tumors or medications, resulting in obesity, high blood pressure, and skin changes. Nursing care involves monitoring electrolytes and glucose, administering hormone replacement therapy, and educating patients.

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Muhammad Husein
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207 views5 pages

Addison Cushing

The document provides a review of Addison's disease and Cushing's syndrome/disease for nursing students preparing for the NCLEX exam. It covers the signs and symptoms, causes, and nursing management of each condition. Addison's disease results from low production of cortisol and aldosterone hormones, causing low blood sugar and sodium levels. Cushing's syndrome/disease occurs when there is high cortisol levels due to tumors or medications, resulting in obesity, high blood pressure, and skin changes. Nursing care involves monitoring electrolytes and glucose, administering hormone replacement therapy, and educating patients.

Uploaded by

Muhammad Husein
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Addisons Disease vs Cushings Review Notes

for NCLEX
April 21, 2016 by S.L. Page
Addisons Disease and Cushings Syndrome/Disease review notes for nursing school and
NCLEX exam. In nursing school and for the NCLEX exam, you will need to know how to
provide care to a patient with either Addisons Disease or Cushings.
However, many students get these two endocrine disorder confused, but these review notes will
help you differentiate between them.

These NCLEX review notes will cover:

Signs and Symptoms of Addisons Disease vs Cushings

Causes of Addisons Disease and Cushings

Nursing Management of Addisons Disease and Cushings

After reviewing these notes, dont forget to take the Addisons Disease vs Cushings Quiz.

Addisons Disease vs Cushings


Major Players in these endocrine disorders:

Adrenal Cortex

Steroid Hormones
o Corticosteroids (specifically Aldosterone (mineralocorticoid) & Cortisol
(glucocorticoid)

Role of Adrenal Cortex: releases steroid hormones and sex hormones


Role of Aldosterone: regulates blood pressure through renin-angiotensin-aldosterone system,
helps retain sodium and secretes potassium (balances sodium and potassium levels).

Role of Cortisol: STRESS Hormone helps the body deal with stress such as illness or injury,
increases blood glucose though glucose metabolism, break downs fats, proteins, and carbs,
regulates electrolytes.

Lecture on Cushings vs Addisons Disease


Cushings (Syndrome & Disease)
Cushings: hyper-secretion of CORTISOL (watch video for clever ways to remember this)
Cushings Syndrome vs Cushings Disease
Cushings Syndrome: caused by an outside cause or medical treatment such as glucocorticoid
therapy
Cushings Disease: caused from an inside source due to the pituitary gland producing too
much ACTH (Adrenocorticotropic hormone) which causes the adrenal cortex to release too
much cortisol.

Signs & Symptoms of Cushings


Remember the mnemonic: STRESSED (remember there is too much of the STRESS hormone
CORTISOL)
Skin fragile
Truncal obesity with small arms
Rounded face (appears like moon), Reproductive issues amennorhea and ED in male(due to
adrenal cortexs role in secreting sex hormones)
Ecchymosis, Elevated blood pressure
Striae on the extremities and abdomen (Purplish)
Sugar extremely high (hyperglycemia)
Excessive body hair especially in womenand Hirsutism (women starting to have male
characteristics), Electrolytes imbalance: hypokalemia
Dorsocervical fat pad (Buffalo hump), Depression

Causes of Cushings

Glucocorticoid drug therapy ex: Prednisone

Body causing it: due to tumors and cancer on the *pituitary glands or adrenal cortex,
or genetic predisposition

Nursing Management for Cushings Syndrome

Prep patient for Hypophysectomy to remove the pituitary tumor

Prep patient for Adrenalectomy:


o If this is done educate pt about cortisol replacement therapy after surgery

Risk for infection and skin breakdown

Monitor electrolytes blood sugar, potassium, sodium, and calcium levels

Addisons Disease
Addisons: Hyposecretion of Aldosterone & Cortisol (watch the video for a clever way on how
to remember this and not get it confused with Cushings)

Signs & Symptoms of Addisons Disease


Remember the phrase: Low STEROID Hormones (remember you have low production of
aldosterone & cortisol which are STEROID hormones)
Sodium & Sugar low (due to low levels of cortisol which is responsible for retention sodium and
increases blood glucose), Salt cravings
Tired and muscle weakness
Electrolyte imbalance of high Potassium and high Calcium
Reproductive changesirregular menstrual cycle and ED in men
lOw blood pressure (at risk for vascular collapse).aldosterone plays a role in regulating BP
Increased pigmentation of the skin (hyperpigmentation of the skin)
Diarrhea and nausea, Depression

Causes of Addisons Disease

Autoimmune due to the adrenal cortex becoming damaged due to the body attacking
itself:
o Tuberculosis/infections
o Cancer
o Hemorrhaging of the adrenal cortex due to a trauma

Nursing Management of Addisons Disease

Watching glucose and K+ level

Administer medications to replace the low hormone levels of cortisol and aldosterone

For replacing cortisol:


o ex: Prednisone, Hydrocortisone

Education: Patient needs to report if they are having stress such as illness,
surgery, or extra stress in life ( will need to increase dosage), take
medication exactly as prescribed.dont stop abruptly without consulting
with MD.

For replacing aldosterone:


o ex: Fludrocortisone aka Florinef

Education: consume enough salt..may need extra salt

Wearing a medical alert bracelet

Eat diet high in proteins and carbs, and make sure to consume enough sodium

Avoid illnesses, stress, strenuous exercise

Watch for Addisonian Crisis


This develops when Addisons Disease isnt treated.
In addisonian crisis, the patient has extremely LOW CORTISOL levels (life threatening).
Remember the 5 Ss

1. Sudden pain in stomach, back, and legs


2. Syncope (going unconscious)
3. Shock
4. Super low blood pressure
5. Severe vomiting, diarrhea and headache

NEED IV Cortisol STAT:


o Solu-Cortef and IV fluids (D5NS to keep blood sugar and sodium levels good
and fluid status)

Watch for risk for infection, neuro status (confusion, agitation), electrolyte levels (sodium
and potassium, glucose)

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