Question

• John Thomas is a 65-year-old client who is part of your caseload for a home care agency. During your visit, he complains of fatigue, anorexia, and recent weight loss. He appears dehydrated with poor skin turgor. Blood pressure is very low—80/46 mm Hg. Physical assessment reveals a dark pigmentation of mucous membranes and skin on knees and elbows. Blood chemistry shows a sodium level of 126 mEq/L and elevated potassium.

1. What condition does the nurse suspects that Mr. Thomas has?
2. What lab work will be ordered to diagnose the client?
3. Describe the treatment for Addison’s disease?
4. What are the adverse effects of treatment with hydrocortisone?

Answer 1

1.Mr thomas has Addison 's disease.

This is a disorder in which adrenal gland does not produce enough hormone like cortisol and aldosterone.

2.ACTH (adrenocorticotropin hormone) stimulation test is considering as the primary diagnostic evaluation of adrenal in sufficiency (to measure the cortisole ). #Insulin tolerance test. # CRH stimulation test(corticotropin releasing hormone test) #Imaging test as, CT scan and MRI scan.

3.This can be treated with medication and hormone replacement therapy(to correct tge hormone deficiency of cortisone and aldosterone)  

#patient will be given with hydrocortisone, prednisolone abd methyl prednisolon to replace cortisol.

#Also treated with flurocortisone acetate to replace aldosterone.

# The patient must consume a high salt diet to manage the sodium level.

4.Adverae effect of treatment with hydrocortisone .

* It is a steroid hormone that blocks certain proteins in our body. With this treatment the patient will feel decreased appetite, irritability, insomnia, stomach upaset and imapred wound healing