ADRENAL GLAND DISORDERS Disorders of the adrenal glands include those related to hypofunction, which can lead to acute

or chronic insufficiency, and those related to hypofunction (overactivity), which most often leads to overproduction of androgen or cortisol. Acute Adrenocortical Insufficiency Insufficiency (hypofunction) of the adrenal gland may be either acute or chronic. In many adrenal syndromes, only one hormone is involved, and the symptoms are directly related only to that hormone. In acute adrenocortical insufficiency the function of the entire cortical adrenal gland suddenly becomes insufficient. Usually this occurs in association with severe overwhelming infection, typically involving hemorrhagic destruction of the adrenal glands. It is seen most commonly in meningococcemia. It also can occur when corticosteroid therapy that has been maintained at high levels for long periods is abruptly stopped. Assessment Assessment are acute and sudden y y y y y y y y y y y BP drops Ashen gray skin color Maybe pulseless Fever Dehydration Hypoglycemia Na and Cl are low Serum K are elevated Prostate Seizures may occur Death can occur without treatment

Therapeutic Management y y y y y y Replacement of cortisol Administration of deoxycorticosterone acetate (DOCA) Synthetic equivalent of aldosterone IV 5% glucose in normal saline solution to restore BP, Na, blood glucose levels Vasoconstrictor (to elevate BP) Antibiotics

The adrenal glands contain 2 parts 1. Cortex

2. Medulla Cortex- outer covering, secretes various types of steroid hormones that control many vital functions Regulate metabolism to supply quick energy Maintain fluid and electrolyte balance Regulate development of secondary sex characteristics Medulla- stimulated by SNS Secretes the hormones epinephrine (adrenaline) & norepinephrine CUSHING S SYNDROME (hyperadrenalism) results from overproduction of hormones secreted by the adrenal cortex; or overuse of corticosteroids or tumors of the adrenal glands or the pituitary. Face is rounded Abnormal fat distribution Heavy abdomen and hangs down Arms & legs are thin When the disease progresses, client becomes weaker, the bones soften, client becomes backache Edema Decrease urinary output Hypokalemia Hypernatremia Hyperglycemia Hypertensive Wounds do not heal Bruises easily Mood swings Irritability & euphoric Striae Primary Aldosteronism Excessive secretion of aldosterone Symptoms Hypertension Muscle weakness d/t low potassium levels Surgery to tumors or excessive growth of adrenal glands Addison s Disease Destruction or degeneration of adrenal cortex