Addisonian Crisis

  1. General information
    1. Severe exacerbation of Addison's disease caused by acute adrenal insufficiency
    2. Precipitating factors
      1. Strenuous activity, infection, trauma, stess, failure to take prescribed medications
      2. Iatrogenic: surgery on pituitary or adrenal glands, rapid withdrawal of exogenous steroids in a client on long-term steroid therapy
  2. Assessment findings: severe generalized muscle weakness, severe hypotension, hypovolemia, shock (vascular collapse)
  3. Nursing interventions
    1. Administer IV fluids (5% dextrose in saline, plasma) as ordered to treat vascular collapse.
    2. Administer IV glucocorticoids (hydrocortisone [Solu-Cortef]) and vasopressors as ordered
    3. If crisis precipitated by infection, administer antibiotics as ordered.
    4. Maintain strict bed rest and eliminate all forms of stressful stimuli.
    5. Monitor vital signs, I&O, daily weights.
    6. Protect client from infection.
    7. Provide client teaching and discharge planning: same as for Addison's disease.