Unit 6 - Addison's Disease
What is an expected finding in a client with adrenal crisis (addisonian crisis)?
Pain
Which outcome is a priority for the client with Addison's disease?
maintenance of medication compliance
The client with Addison's disease is taking glucocorticoids at home. Which statement indicates that the client understands how to take the medication?
"Various circumstances increase the need for glucocorticoids, so I will need to adjust the dosage."
A client with Addison's disease is taking corticosteroid replacement therapy. The nurse should instruct the client about which side effects of corticosteroids? Select all that apply.
- skeletal muscle weakness - mood changes - hypocalcemia - increased susceptibility to infection
A client has been diagnosed with Addison's disease. The nurse should plan with the client to manage which effect of the disease?
Lethargy
Cortisone acetate and fludrocortisone acetate are prescribed as replacement therapy for a client with Addison's disease. What administration schedule should be followed for this therapy?
Take all the fludrocortisone acetate and two-thirds of the cortisone acetate in the morning, and take the remaining cortisone acetate in the afternoon.
After stabilization of Addison's disease, the nurse teaches the client about stress management. What should the nurse instruct the client to do?
Use relaxation techniques such as music.
A client with Addison's disease has fluid and electrolyte loss due to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As the client's oral intake increases, which fluids would be most appropriate?
chicken broth and juice
Which indicator is best for determining whether a client with Addison's disease is receiving the correct amount of glucocorticoid replacement?
daily weight
The client is receiving an IV infusion of 5% dextrose in normal saline running at 125 mL/h. When hanging a new bag of fluid, the nurse notes swelling and hardness at the infusion site. The nurse should first:
discontinue the infusion.
The nurse is teaching the client with Addison's disease to anticipate the need for increased glucocorticoid supplementation. When will the client likely need to increase the dose of glucocorticoids?
having oral surgery
The nurse is instructing a college student with Addison's disease how to adjust the dose of glucocorticoids. The nurse should explain that the client may need an increased dosage of glucocorticoids in which situation?
having wisdom teeth extracted
A client newly diagnosed with primary Addison's disease asks the nurse about the cause of the disease. What should the nurse tell the client? "The disease is caused by:
idiopathic atrophy of the adrenal gland."
Which goal is the priority for a client in an Addisonian crisis?
preventing irreversible shock
Which topic is most important to include in the teaching plan for a client newly diagnosed with Addison's disease who will be taking corticosteroids?
the importance of watching for signs of hyperglycemia
When teaching a client about taking oral glucocorticoids, how should the nurse instruct the client to take the medication?
with meals or with an antacid
The nurse is conducting discharge education with a client newly diagnosed with Addison's disease. Which information should be included in the client and family teaching plan? Select all that apply.
- Avoiding stress and maintaining a balanced lifestyle will minimize risk for exacerbations. - Fatigue, weakness, dizziness, and mood changes need to be reported to the health care provider (HCP). - A medical identification bracelet should be worn. - Family members need to be informed about the warning signals of adrenal crisis. - Dental work or surgery will require adjustment of daily medication.