Medical Surgical Addisons vs Cushing #1

Question

The nurse is assessing a client admitted with Addison’s Disease. Assessment findings consist of generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin. Which lab values would the nurse expect to find?

Answers

  1. Hyperkalemia, hypercalcemia
    • Rationale:

      This answer is correct because Addison’s disease is a rare, yet serious disorder of the adrenal gland. Dysfunction of the adrenal glands causes decreased production of cortisol and aldosterone in the body. Electrolyte imbalance (e.g., hyperkalemia, hypercalcemia, and hyponatremia) may occur and may be triggered from stress, trauma, or surgery. Assessment findings consist of generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin. The client should be taught the necessity of lifelong steroid replacement therapy.

  2. Hypokalemia, hypocalcemia
    • Rationale:

      This answer is not correct because hyperkalemia (not hypokalemia) and hypercalcemia (not hypocalcemia) is associated with Addison’s Disease. Hypokalemia and hypocalcemia is associated with too much cortisol and aldosterone, which are symptoms of Cushing’s syndrome.

  3. Elevated cortisol level
    • Rationale:

      This answer is not correct because decreased (not elevated) cortisol levels are associated with Addison’s Disease. Elevated cortisol levels are associated with Cushing’s syndrome.

  4. Elevated glucose level
    • Rationale:

      This answer is not correct because decreased (not increased) glucose levels are most associated with Addison’s disease. Increased blood glucose levels are most associated with increased cortisol levels and Cushing’s syndrome.

Overview

Addison’s disease is a condition where there is not enough cortisol or aldosterone in the body. The client will have lab values reflecting hyperkalemia and hypercalcemia.

Explanation

Learning Outcomes

Addison’s disease, a rare, yet serious disorder of the adrenal gland, is a condition where there is not enough cortisol and aldosterone in the body. Addison’s disease may exhibit laboratory results indicating hyperkalemia, hypercalcemia, low cortisol, low aldosterone levels, low blood glucose levels, and decreased levels of sodium, and low blood pressure. Electrolyte imbalance may occur and can be triggered from stress, trauma, or surgery. Assessment findings consist of generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin. The client should be taught the necessity of lifelong steroid replacement therapy.

Test Taking Tip

Knowing that Addison’s Disease and Cushing’s syndrome are conditions that are directly opposite one another will help to learn these conditions. You can learn just one and know the other is mostly opposite. Then you can add the things that might be different (hyperpigmentation of Addison’s Disease) and it makes remembering these conditions easier.

Video Rationale