Medical Surgical Addisons vs Cushing #2

Question

The nurse develops discharge teaching for a client with Addison’s Disease. What is the most important topic in teaching about hormone replacement therapy?

Answers

  1. Stopping steroid doses when stress or illness occurs
    • Rationale:

      This answer is not correct because Addison’s disease is a dysfunction of the adrenal glands that causes decreased production of cortisol and aldosterone in the body. The client may need more (not less) steroid medication during periods of stress or illness. The client should also be taught the necessity of lifelong steroid replacement therapy.

  2. To maintain lifelong steroid replacement therapy
    • Rationale:

      This answer is correct because discharge teaching for a client with Addison’s Disease should include the importance of maintaining lifelong steroid replacement therapy. This is because Addison’s disease is a condition where there is not enough cortisol and aldosterone in the body due to adrenal dysfunction. Assessment findings consist of electrolyte imbalances, generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin.

  3. Monitor liver function through monthly blood tests
    • Rationale:

      This answer is not correct because although periodic liver function tests are important to check, it is not necessary to monitor liver function tests monthly. Liver function should be monitored because adrenocortical insufficiency from Addison’s Disease can cause a rare increase of liver enzymes.

  4. To limit dietary intake of protein and sodium
    • Rationale:

      This answer is not correct because a client with Addison’s Disease should have a diet high in protein, high in carbohydrates, and with normal sodium. Low protein and carbohydrate would be detrimental for nutritional status since the client will most likely have weight loss.

Overview

Discharge teaching for a client with Addison’s Disease should include the importance of maintaining lifelong steroid replacement therapy. This is because Addison’s disease is a condition where there is not enough cortisol and aldosterone in the body due to adrenal dysfunction.

Explanation

Learning Outcomes

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 may occur and may be triggered from stress, trauma, or surgery. Assessment findings consist of generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin. Discharge teaching should include being taught the necessity of lifelong steroid replacement therapy.

Test Taking Tip

Think ADrenal insufficiency is ADDison’s Disease.

Video Rationale