Question

Medical diagnosis is Addison’s disease.

Mrs. Adrenalina is a nursing home patient and seems to be complaining to the nurse that she has not been feeling well for several months now. She reports that the doctors have beern doing test on her and all they can seem to find is a thyroid problem. She reports that she started levothyroxine but it doesn't seem to be helping. She complains of having fatigue, weakness, and weight loss. She tells the nurse that when she stands up she gets very dizzy and feels like she might fall. The patient has a low blood pressure, increased thirst and heart rate seems a little irregular. The nurse checks her blood sugar and it seems to be noted as hypoglycemia. . What does this patient have? (Medial Diagnosis) . Make up some V/S for this patient . What test/ labs should be performed on this patients? After reading you situation and forming your answer(s), please write a nurse's note over your patient and the assessment finds/ needs Create a care plan for this patient with a: nursing diagnosis 2 interventions 2 goals.

Answer 1

1.Medical diagnosis is Addisons disease.

3.In addition to clinical features, a diagnosis of Addisons disease can be made when cortisol levels are subnormal or fail to rise over basal levels with an ACTH -stimulation test. Other abnormal laboratory finding include hyperkalemia, hypochloremia, hyponatraemia, hypoglycemia, anaemia and increased blood urea nitrogen levels. Urine levels of free cholesterol are low. An Ecg may show low voltage and peaked T waves caused by hyperkalaemia. CT scans and MRI are used to localize tumors or identify adrenal calcification or enlargement.

4.When the patient with Addison's disease is hospitalized, whether for diagnosis, an acute crisis, or some other health problem, frequent nursing assessment is necessary. Vital signs and signs of fluid volume deficit and electrolyte imbalance should be assessed.. In addition daily weights, dilgent corticosteroid administration, protection against exposure to infection and complete assistance with daily hygeine should be practiced.The patient should be protected from noise, light and environmental temperature extremes.

5.Deficient fluid volume related to hypovolaemia secondary to adrenal insufficiency.

Intervention

• Monitor intake and output closely.
• Monitor vital signs and skin turgor every two hours.

Goals

• Regain normal fluid balance.
• Regain normal peripheral perfusion with blood pressure within normal range.