Understanding Addison’s Disease – NCLEX Guide to Adrenocortical Insufficiency

Addison’s disease, or adrenocortical insufficiency, occurs when the adrenal glands fail to produce enough cortisol and aldosterone. This endocrine disorder is high-yield for the NCLEX, and recognizing its signs, symptoms, and management is crucial for safe nursing practice.

This blog, featuring a King of the Curve (KOTC) proprietary visual, simplifies the key points you need to remember for the NCLEX exam.

Pathophysiology of Addison’s Disease

The adrenal glands secrete cortisol, aldosterone, and androgens. In Addison’s disease, autoimmune destruction, infections, or abrupt withdrawal from corticosteroids lead to adrenal insufficiency.

Hormonal Effects in Addison’s Disease:

📉 Low Cortisol → Hypoglycemia, weakness, fatigue
📉 Low Aldosterone → Hyponatremia, hyperkalemia, dehydration
📉 Low Androgens → Weight loss, anorexia

Signs & Symptoms of Addison’s Disease

🟤 Bronze Skin Pigmentation – Due to excess ACTH stimulating melanin production
🍬 Hypoglycemia – Low cortisol affects blood sugar regulation
💨 Tachycardia & Postural Hypotension – Due to low aldosterone and sodium loss
🍽 Weight Loss & Anorexia – From metabolic dysfunction
🩸 GI Disturbances – Nausea, vomiting, diarrhea
⚡ Profound Weakness & Fatigue – Common due to lack of cortisol
😞 Depression & Irritability – Due to hormonal imbalances

Adrenal Crisis – A Life-Threatening NCLEX Emergency!

Without treatment, Addison’s disease can progress to an adrenal crisis, which is a medical emergency.

🚨 Signs of Adrenal Crisis:
🔻 Severe hypotension & vascular collapse
🔻 Profound fatigue & dehydration
🔻 Hyponatremia (↓ Na+) & Hyperkalemia (↑ K+)
🔻 Hypoglycemia

NCLEX Tip: Always taper steroids gradually! Abrupt withdrawal can trigger an adrenal crisis.

NCLEX Nursing Management of Addison’s Disease

💉 Medications:
✔ Hydrocortisone or Prednisone – Lifelong steroid replacement
✔ Fludrocortisone – If aldosterone deficiency is severe

⚠️ Nursing Interventions:
✔ Monitor vital signs & electrolytes – Watch for hypotension, hyperkalemia
✔ Increase salt intake – To counteract aldosterone loss
✔ IV fluids & glucose – For adrenal crisis management
✔ Educate on steroid therapy – Must never skip doses!

NCLEX Practice Question

A patient with Addison’s disease presents with severe hypotension, confusion, and hyperkalemia. What is the priority nursing intervention?
A) Administer IV insulin and dextrose
B) Prepare for dialysis
C) Administer IV hydrocortisone and fluids
D) Restrict sodium intake

💡 Answer: C) Administer IV hydrocortisone and fluids – This is the primary treatment for adrenal crisis.

Conclusion

Understanding Addison’s disease is essential for the NCLEX exam, as questions frequently test its symptoms, adrenal crisis, and nursing interventions.

📌 Want more NCLEX visuals? Visit King of the Curve NCLEX Resources for high-yield illustrations that simplify complex medical concepts!

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Frequently Asked Questions (FAQs)

• How many hours should I study for the MCAT each day?

  Aim for 4-6 focused hours, ensuring you incorporate breaks to avoid burnout.

• What is the best way to handle test anxiety?

  Practice mindfulness techniques, take practice exams under realistic conditions, and maintain a balanced lifestyle.

• How can I stay motivated during the long application process?

  Set short-term goals, seek support from mentors, and reward yourself for small achievements.

• What role does exercise play in MCAT preparation?

  Regular exercise improves focus, reduces stress, and enhances overall mental clarity.

• How does King of the Curve help with MCAT preparation?

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