Question

Please answer for study guide:

1. What will be some patient teachings for Addison’s and Cushings?
2. What will be some patient teaching for hypothyroidism and hyperthyroidism?
3. Are there any lab values to be concerned about for Addison’s? If so, what are they?

Answer 1

Patient teachings for Addison’s disease.

Addison’s disease is an uncommon disorder of the adrenal glands which is characterized by the deficiency of aldosterone and cortisol hormone. Cortisol helps the body to manage stress and aldosterone helps to maintain the balance of sodium, potassium, water and blood pressure.

A sudden drop in aldosterone and cortisol causes adrenal crisis leading to hypotension, dehydration and low blood glucose. This is life threatening and requires immediate treatment.

Seek medical help immediately if you experience the following:

• Increased heart rate

• Feeling of headaches, confusion or hallucinations.

• Severe pain in the stomach, legs and back.

• Muscle cramps or weakness.

• Tingling and numbness in your fingers.

• Fever, cold or flu

• Nausea, vomiting or diarrhea

• Seizure

• Breathlessness

Always carry an identification or wear a medical alert bracelet alerting you have Addison’s disease.

Carry an injectable corticosteroid with instructions for administration during an emergency.

Regularly visit the doctor and never avoid or skip your medications. During days when you feel more stressed, consult the doctor for medication dose adjustments.

Monitor blood sugar and blood pressure on regular basis.

Patient teachings for Cushing syndrome.

Cushing syndrome is a condition where the cortisol levels are high in the body. Cortisol is a hormone produced by the adrenalin glands, and help in dealing with stress and helps maintain the blood pressure and blood sugar levels to normal.

Seek medical help immediately if you experience the following:

• Blurred vision
• Headache and or dizziness.
• Chest pain
• Shallow breathing or difficulty in breathing
• If you feel confused.
• Severe pain which does not reduce even after taking the pain medicine.

Cushing syndrome can elevate the blood sugar levels, hence it is necessary to manage the blood sugar levels with appropriate food and medicines.

Increase in cortisol levels may also increase stress and anxiety levels. Include relaxing techniques such as deep breathing in your daily regimen.

Eat foods rich in healthy fats, fiber, vitamins and minerals, and foods that are low in cholesterol sodium.

Monitor body weight regularly and at the same time every morning before you eat, as extra weight indicates extra fluid in the body.

Patient teachings for Hypothyroidism.

Hypothyroidism is the most common type of thyroid disorder, where the thyroid gland does not produce sufficient thyroid hormone. This results in improper functioning of the body causing mental and physical sluggishness.

Seek medical help when you experience the following:

• Fatigue

• Irregular heartbeat

• Confusion

• Abnormal weight loss or weight gain.

• Puffy face, hands or feet

Make sure to take your medications at the same time every day.

Take the medication one hour before breakfast.

Never stop the medication on your own.

Take your other medications such as vitamins, calcium or iron tablets at least 4 hours after taking the thyroid medicine.

Eat a diet containing high fiber and low calorie to ease constipation.

Exercise regularly to maintain a healthy body.

Patient teachings for Hyperthyroidism.

Hyperthyroidism is caused when the thyroid glands produce too much of thyroid hormone. This results in change in the body function causing physical, emotional and behavioral changes.

Seek medical help during the following situations:

• Shortness of breath

• Anxiety, or sleeplessness

• Bulging eyes

• Weight loss

• Diarrhea

• Rapid heartbeat

• Enlarged thyroid gland

Take the medicines as prescribed by the doctor.

Do not stop taking the medications if the symptoms have reduced or feeling better.

Take the medications at the same time every day.

Keep a track of your symptoms.

Follow up with the doctor regularly or as and when required.

Lab values for Addison’s disease.

An individual with Addison’s disease will often have low sodium, chloride and carbon dioxide and high amounts of potassium. The following laboratory tests are done for effective understanding and treatment.

Cortisol – A cortisol test in combination with ACTH tests to diagnose the adrenal insufficiency.

ACTH – This test is done to evaluate the functioning of pituitary gland. Low levels of ACTH indicates secondary adrenal insufficiency whereas high levels indicate Addison’s disease.

Aldosterone - This test is done to determine the functioning of adrenal gland. If the levels are low, it indicates the presence of primary adrenal insufficiency/ Addison’s.

BUN and creatinine are performed to monitor the kidney function.

Electrolytes- This test is done to help detect the severity of the fluid imbalance. With Addison’s, the chloride, sodium, and carbon dioxide levels are low and potassium levels are high.