Master Addisonian Crisis with Picmonic for Nursing RN

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Addisonian Crisis

Add-sun with Crying-crisis
Picmonic
This is a life-threatening emergency, which involves intense nursing care to address the signs and symptoms of acute adrenal insufficiency. It often occurs as an outcome from a stressful situation, such as surgery, trauma, severe infection, or the sudden withdrawal of exogenous corticosteroids.
7 KEY FACTS
ASSESSMENT
Severe Symptoms
Severed Sx-guy

Symptoms are severe including profound hyponatremia leading to hypotension, confusion and muscle weakness, as well as hyperkalemia which may cause ECG changes.

Shock
Shocking

The most important consideration is the management of hypovolemic shock. These patients often require large volumes of IV solutions to maintain adequate perfusion to tissues.

INTERVENTIONS
High-Dose Hydrocortisone
High Dose Hydrant-court judge

High dose IV hydrocortisone is indicated to replenish depleted cortisol levels and maintain glucose metabolism.

Large Volumes of IV Fluid
Large IV-bag

Large volumes of IV normal saline are indicated to maintain blood pressure. Assess patients often for signs and symptoms of fluid overload, monitor intake and output regularly.

Insulin with Dextrose
Insect-syringe with Sugar-rose

Insulin is given to patients with hyperkalemia, as it causes a shift of potassium back into cells decreasing serum potassium levels. Giving dextrose alongside an insulin infusion prevents hypoglycemia.

Kayexalate
Kayak

Sodium polystyrene sulfonate (Kayexalate) is given by mouth, through a gastric tube or in the form of an enema solution. It contains a high salt content that causes an excretion of potassium and is indicated for patients with hyperkalemia. 

Loop or Thiazide Diuretics
Loop-hen and Tarzan Die-rockets

Diuretics, especially loop diuretics, may be indicated due to their side effect of decreasing potassium levels. It is important to consider additional fluid volume replacement in these patients.

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