ADDISONS DISEASE

Definition: Addison's disease is an endocrine or hormonal disorder that occurs in all age groups and afflicts men and women equally. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non exposed parts of the body. Risk factors: a. Family history of Addisons disease b. Cancer c. Tuberculosis d. Diabetes e. Thyroid disease Pathophysiology: production of adrenocortical hormone

destruction of 3 layers of the adrenal cortex (glomerulosa, fasciculate and reticularis)

disruption of hormone synthesis Causes: a. b. c. d. e. f. g. h. i.

Tuberculosis Polyendocrine deficiency syndrome Chronic infections - mainly fungal infections Adrenal cancer Adrenal gland physical damage Adrenal dysgenesis Impaired steroidogenesis Adrenal destruction Corticosteroid withdrawal

Clinical Manifestations: a. Abdominal pain b. Decreased body hair c. Dehydration d. Diarrhea or constipation e. Dizziness and fainting f. Fatigue g. Joint and muscle aches h. Low blood pressure i. Hypoglycemia j. Muscle weakness k. Salt craving l. Vomiting m. Weight loss

 Diagnostic and Laboratory tests: a. ACTH Stimulation Test b. Hypercalcemia c. Hypoglycemia, low blood sugar d. Hyponatremia (low blood sodium levels), e. Hyperkalemia (raised blood potassium levels), f. Eosinophilia and lymphocytosis (increased number of eosinophils or lymphocytes, two types of white blood cells) g. Metabolic acidosis (increased blood acidity) h. Imaging tests i. BUN and Creatinine are tests Medical management: a. Oral corticosteroids b. Corticosteroid injections c. Androgen replacement therapy d. Fludrocortisone acetate e. Prednisolone Nursing management: a. Monitor vital signs b. Increase fluid intake (3000 ml) c. Diet that is high in sodium and low in potassium d. Assist during activit

TONSILITIS
Definition: Tonsillitis is an inflammation of the tonsils, the fleshy clusters of tissue on both sides of the back of the throat that fight off germs that enter the body through the mouth. The tonsils become enlarged and red, and have a yellow or white coating. Risk factors: a. Young age b. Frequent exposure to germs Pathophysiology: Inflammation in the area tonsila from the virus Exudateformation Cellulitis occurstonsila and the surrounding area Peritonsilar abscess formation Tissue necrosis. Causes: a. b. c. d. e.

Beta hemolytic streptococci H influenza type B Influenza virus Herpes simplex Nesseriagonorrhoeae

Clinical Manifestations: a. sore throat b. red, swollen tonsils c. pain when swallowing d. high temperature (fever) e. coughing f. headache g. Tiredness h. chills i. malaise j. white pus-filled spots on the tonsils k. swollen lymph nodes (glands) in the neck l. pain in the ears or neck Diagnostic and Laboratory tests: a. Throat swab b. Complete blood cell count (CBC) Medical management: a. Penicillin b. Erythromycin c. Ibuprofen d. Acetaminophen

e. sore throat relief (warm salt water gargle, lozenges, and iced/cold liquids) Nursing management: a. Bed rest. b. Provision of adequate fluids and light diet c. Giving medications (analgesics and antibiotics) d. If no progress then the alternative measures that can be done is surgery