96760
Beschreibung
Mindmap von becky.rawlinson, aktualisiert more than 1 year ago
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Erstellt von becky.rawlinson
vor fast 11 Jahre
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Addisons disease/ crisis
- "Pathophysiology"
- Brought about by the destruction of the Adrenal
gland - usually via an auto-immune pathway
- Destruction leads to marked decreases in Aldosterone and
Cortisol (adrenocortical hormones released natually from the
adrenal gland)
- ALDOSTERONE
- Acts on the Kidneys to improve blood pressure
- Increases blood volume by increasing water retention -
caused by heightened sodium and chloride re-absorption &
increased potassium excretion
- Increases blood volume by increasing water retention -
caused by heightened sodium and chloride re-absorption &
increased potassium excretion
- Acts on the Kidneys to improve blood pressure
- CORTISOL
- Acts in response to stress
- Reduces sodium loss, aids in metabolism, increases blood sugar
level (via insulin) & suppresses the immune system
- Reduces sodium loss, aids in metabolism, increases blood sugar
level (via insulin) & suppresses the immune system
- Acts in response to stress
- Reductions in these hormones cause
dramatically lowered blood pressure and
volume due to water loss and less
sodium/chloride retention
- ALDOSTERONE
- Destruction leads to marked decreases in Aldosterone and
Cortisol (adrenocortical hormones released natually from the
adrenal gland)
- Brought about by the destruction of the Adrenal
gland - usually via an auto-immune pathway
- "Clinical signs"
- Non -specific = mimics
other diseases therefore
making it difficult to
diagnose
- Loss of body condition
- Anorexia
- Emesis
- Diarrhoea
- Increased water loss
- Dehydration
- Dehydration
- Gastroenteritis
- Anorexia
- Hypotension
- Circulatory collapse
- Shock
- Circulatory collapse
- Increased potassium levels
- Bradycardia
- Irregular heart beat
- Bradycardia
- Hypoxia due to lessened perfusion
- RENAL FAILURE
- RENAL FAILURE
- Increased ACTH release
from pituitary
- Hyperpigmentation of the skin
- Hyperpigmentation of the skin
- Non -specific = mimics
other diseases therefore
making it difficult to
diagnose
- "Diagnosis"
- ACTH stimulation test
- Adrenocorticotrophic hormone is usually released from
the anterior pituitary in order to stimulate the adrenal
gland to produce Cortisol
- A healthy animal will have heightened cortisol levels following
injection whereas an Addison's sufferer will have no change
- A healthy animal will have heightened cortisol levels following
injection whereas an Addison's sufferer will have no change
- Blood test prior to injection. 1ml
synthetic ACTH injected (Synactin).
Blood test 1 hour post injection.
- Adrenocorticotrophic hormone is usually released from
the anterior pituitary in order to stimulate the adrenal
gland to produce Cortisol
- ACTH stimulation test
- "Aims of treatment"
- Acute medical emergency
- Stabilise patient ASAP
- Stabilise patient ASAP
- FLUIDS
- Support vascular systems & reduces shock
- NO HARTMANS- contains K +
- NO HARTMANS- contains K +
- Sodium chloride (Saline) administered to
reduce hyperkalaemia and improve sodium and
chloride levels
- Support vascular systems & reduces shock
- STEROIDS
- Synthetic glucocorticoid
(Prednisolone sodium succinate)
- Short-course Preds once stable - not
long term as animal cna usually cope
with glucocorticoid insufficiency (Cortisol)
- Once stable maintained on a synthetic minercorticoid (Florinef)
in order to compensate for Aldosterone reduction
- Synthetic glucocorticoid
(Prednisolone sodium succinate)
- HYPERKALAEMIA
- Dangerous in an emergency situation - capable of
causing serious cardiac dysfunction
- Small dose of insulin causes cellular uptake of
Potassium - therefotre lowering blood concentration
- Ahee and Crowe, 2000
- NO steroids in this
situation until insulin has
stopped being effective
as they can promote
insulin resistance
- Ahee and Crowe, 2000
- Small dose of insulin causes cellular uptake of
Potassium - therefotre lowering blood concentration
- Dangerous in an emergency situation - capable of
causing serious cardiac dysfunction
- Acute medical emergency
- NURSING TREATMENT
- MONITORING
- Regular electrolyte measurements
- Temp
- Fluids
- Regular electrolyte measurements
- Regular trips outside to toilet if capable
- Potentially
incontinent - INKA
pad
- Check hygiene constantly
- Not weeing = need diruetics
- Potentially
incontinent - INKA
pad
- Offer renal diet when stable
- Home ASAP to prevent stress
- Recumbent patient - comfy bed & regular turning
- Recommend home visits &
zylkene to reduce stress
- MONITORING
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