Adrenal insufficiency is a deceptive disorder. Insidious in onset, chronic in nature, it can suddenly progress into an acute life-threatening condition that may mimic disorders of vastly different etiologies. The result can be a lethal delay in diagnosis. Prompt diagnosis and replacement of glucocorticoids and fluids are essential for survival. Acute adrenal insufficiency is frequently an exacerbation of an underlying chronic disorder of the adrenal cortex or pituitary gland. Yet any patient who has been treated with suppressive doses of glucocorticoids (e.g., Cortisol, prednisone), experienced overwhelming sepsis, has received anticoagulant therapy, or has endstage metastatic carcinoma may suddenly develop adrenal insufficiency along with its deadly sequela of hypovolemic shock, hyperkalemia, hyponatremia, and hypoglycemia. Successful management of this condition requires not only a heightened clinical awareness of adrenal insufficiency, but effective stress reduction interventions and a thorough patient and family teaching program to support lifelong control of the disease
Endocrine Disorders| May 01 1992
Adrenocortical Insufficiency: A Medical Emergency
Laura M. Lee, RN, BSN;
*From the Quality Assurance Service, Clinical Center, National Institutes of Health, Bethesda, Maryland.
Reprint requests to Laura M. Lee, RN, BSN, Quality Assurance Service, Clinical Center, Building 10, Room 2C-144, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892.
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AACN Adv Crit Care (1992) 3 (2): 319–330.
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Laura M. Lee, Julle Gumowski; Adrenocortical Insufficiency: A Medical Emergency. AACN Adv Crit Care 1 May 1992; 3 (2): 319–330. doi: https://doi.org/10.4037/15597768-1992-2005
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