Page 1415 - Saunders Comprehensive Review For NCLEX-RN

Adrenal Medulla

▪ Pheochromocytoma

Table 46-1

Assessment: Addison’s Disease and Cushing’s Disease and Cushing’s Syndrome

Addison’s Disease Cushing’s Disease and Cushing’s Syndrome
Lethargy, fatigue, and muscle weakness Generalized muscle wasting and weakness
Gastrointestinal disturbances Moon face, buffalo hump
Weight loss Truncal obesity with thin extremities, supraclavicular fat pads;
weight gain
Menstrual changes in women; impotence in men Hirsutism (masculine characteristics in females)
Hypoglycemia, hyponatremia Hyperglycemia, hypernatremia
Hyperkalemia, hypercalcemia Hypokalemia, hypocalcemia
Hypotension Hypertension
Hyperpigmentation of skin (bronzed) with primary Fragile skin that bruises easily
disease Reddish-purple striae on the abdomen and upper thighs

Box 46-8

Addisonian Crisis

▪ A life-threatening disorder caused by acute adrenal insufficiency
▪ Precipitated by stress, infection, trauma, surgery, or abrupt withdrawal of
exogenous corticosteroid use

▪ Can cause hyponatremia, hyperkalemia, hypoglycemia, and shock

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