Lab medication administration procedures, Summaries of Nursing

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By: Leslie, Joie, & Ali

Feb 09, 2026

Addison’s Diseases

Primary adrenal insufficiency - adrenal cortex fails

to produce cortisol, aldosterone, sometimes

androgens

1. Low cortisol (reduced stress respone,

hypoglycemia)

2.Low aldosterone (sodium loss, potassium

retention)

3. High ACTH - skin hyperpigmentation

* ACTH: Adrenocorticotropic hormone

Risk factors

Autoimmune diseases:

Type 1 Diabetes

Thyroid Disorders

History of adrenal infection

Long-term steroid withdrawal

Family history of autoimmune disease

Tip: Think “autoimmune + adrenal injury + family history”

Signs and Symptoms

Fatigue, weakness

Weight loss, loss of appetite

Nausea & Vomiting

Hypotension, salt craving

Hyperpigmented skin

Hypoglycemia

Balanced diet

Adequte salt intake

Medical alert bracelet

Regular follow-up

Stress management

Non-Pharmacologic

NURSING INTERVENTION:

Pharmacologic

PATIENT TEACHING

Glucocorticoids: Hydrocortison, Prednisone

Mineralcorticoids: Fludrocortisone

IV

hydrocortisone & fluid in crisis

Monitor BP, electrolytes, glucose Assess for signs of crisis Administer steroids as prescribed Maintain fluid balance

Never stop steroids abruptly Increase dose during stress/illness Carry emergency steroid kit Recognize crisis symptoms

Cushing’s Diseases

Form of Cushing’s syndrome caused by pituary

gland, excess ACTH, excess cortisol

1.Pituitary adenoma secretes excess ACTH

2.Adrenal cortex stimulated - cortisol excess

3.Effects cortisol excess

Increased glucose

fat redistribution - moon face, buffalo hump

Protein breakdown - thin limbs, weak muscles

Suppressed immune system - higher infection risk

Risk factors

Long-term steroids theraphy

Pituary/adrenal tumors

Obesity

Type 2 diabetes

Hypertension

Tip: Think “steroid exposure + metabolic issues.”

Signs and Symptoms

Moon face, buffalo hump, central obesity

Thin arms & legs

Purple striae on abdomen

Apperance:

Hypertension

Hyperglycemia

Muscle weakness

Weight management

Low- sodium

Infection prevention

Stress reduction

Non-Pharmacologic

NURSING INTERVENTION:

Pharmacologic

PATIENT TEACHING:

Cortisol- lowering drugs

Surgery for tumor removal

Radiation theraphy

Monitor BP, electrolytes, glucose Assess for infection Skin care (fragile skin) Promote mobility & safety

Take medications as prescribed Monitor blood sugar Follow dietary recommendations Report infection signs Maintain follow-up appointments

Cushing’s vs Addison’s-

Comparison Overview:

FEATURE CUSHING’S DISEASE

Cortisol

ADDISON’S DISEASE

Blood pressure

Weight

Skin

Glucose

High

High

Gain

Thin skin, striae

High

Low

Low

Loss

Hyperpigmented

Low

Electrolytes Variable^ Low sodium, high potassium