About
A decrease in adrenalcortical steroid production, resulting in either acute, life threatening crisis or chronic, gradual disease. One of the most common causes of acute crisis is sudden withdrawal from glucocorticosteroids. These must be withdrawn slowly and tapered when given to clients.
Assess
Assess for hypoglycemia, hyperkalemia, dehydration. Assess VS, including postural blood pressure changes resulting from hypovolemia. Assess for abdomen pain, appetite changes, weight loss, fatigue, muscle pain, and joint pain. Assess BUN, lytes, glucose, cortisol, and CBC.
Complications
Severe hyponatremia; hyperkalemia; severe hypotension; hypoglycemia
Diagnosis
- Deficient fluid volume related to failure of regulatory mechanism
- Activity intolerance related to muscle weakness and fatigue
- Risk for injury related to muscle weakness
Goals
- The client will have adequate fluid balance.
- The client will remain free from injury.
- The client will be able to tolerate activities of daily living.
Interventions
- Monitor VS, electrolytes, blood glucose levels, intake/ output, daily weights, neurological status.
- Institute safety precautions to prevent injury.
- Monitor for dysrhythmias.
- Monitor for postural hypotension and assist with ambulation.
- Administer medications ( glucocorticoids, mineral corticoids, etc.) and fluids, as ordered.
- Monitor for signs/ symptoms of complications.
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