Master Addison's Disease Intervention with Picmonic for Nursing RN

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Addison's Disease Intervention

Add-sun Interventions
Picmonic
The focus of treatment of Addison’s disease is hormone therapy and the prevention of Addisonian Crisis. Acute nursing management involves monitoring fluid and electrolyte balance, promoting adequate fluid volume, and monitoring for hypoglycemia and hypotension. 
9 KEY FACTS
DRUG THERAPY
Hydrocortisone
Hydrant-court

Hydrocortisone (Cortef) is a synthetic glucocorticoid medication that replaces lost cortisol. Doses vary based on patient weight and metabolism, typically 20-50 mg. Remember to assess for signs and symptoms of Cushing’s syndrome, as these patients will take these medications throughout the duration of their lives and may require dosage adjustment. Always gradually taper glucocorticoid medications as exogenous medications suppress ACTH.

2/3 Dose in Morning
2/3 with the Morning-sun

In the normal body cortisol levels peak in the morning and as such patients can take their entire daily dose of hydrocortisone in the morning, immediately after waking. If this schedule results in afternoon or evening fatigue, patients may split the dosage, taking two-thirds in the morning.

1/3 Dose in Late Afternoon
1/3 with the setting Afternoon-sun

The remaining one-third of the daily dose of hydrocortisone can be given around 4:00 in the afternoon in an attempt to mimic the body’s rhythmic release of cortisol.

Fludrocortisone
Flooded-court

Fludrocortisone (Florinef) is a synthetic mineralocorticoid medication that is taken in the morning daily. It is administered additionally to patients lacking aldosterone for sodium retention and potassium excretion in the kidney. Remember to assess for hypertension and fluid overload from excessive sodium retention.

Androgen Replacement Therapy
&-droid-genie Replacement

The adrenal cortex produces androgens and replacement therapy is needed especially in females. This may only be needed in serious conditions.

CONSIDERATIONS
Salt Additives
Salt Added to food

Salt additives must be supplemented in patients because patients are unable to retain sodium naturally, especially during periods of salt loss like sweating with exercise and in hot temperatures.

Increase Dosage During Stress and Infection
Up-arrow IV with Stress and Bacteria

During periods of stress or infection dosages of medications like hydrocortisone may need to be increased as the body’s metabolic demands are increased. Likewise, with strenuous exercise or in times of increased sweating, additional salt intake will be required to maintain homeostasis.

Medic Alert Bracelet
Medic Alert Bracelet

A bracelet can allow emergency personnel to quickly identify the patient’s needs in the event the patient is unconscious or unable to communicate.

Lifelong Hormone Therapy
Lifelong-commitment Harmonica

Patients will require hormone replacement therapy for the duration of their lifetimes as there is no cure for this disease.

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