Differences Between Addison’s Disease and Cushing’s Disease

Overview

• Focus on Addison’s Disease and Cushing’s Disease as part of NCLEX review.
• Discuss causes, signs, symptoms, nursing interventions, and mnemonics.
• Related to adrenal cortex and steroid hormones: aldosterone and cortisol.

Key Players

• Adrenal Cortex:
  • Located atop kidneys.
  • Releases corticosteroids (aldosterone, cortisol) and sex hormones.
• Aldosterone (Mineral Corticoid):
  • Regulates blood pressure via renin-angiotensin-aldosterone system.
  • Retains sodium, secretes potassium.
• Cortisol (Glucocorticoid):
  • Known as the stress hormone.
  • Increases blood glucose, breaks down fats/proteins/carbs, regulates electrolytes.

Negative Feedback Control

• Hypothalamus releases CRH → Pituitary Gland releases ACTH → Adrenal Cortex releases cortisol.

Cushing’s Disease

• Increased secretion of cortisol (stress hormone).
• Remember: Cushing starts with C, so does cortisol.

Causes

• Cushing’s Syndrome: Outside cause (medication like prednisone).
• Cushing’s Disease: Inside cause (e.g., pituitary gland overproducing ACTH).

Signs & Symptoms (Mnemonic: STRESSED)

• Skin fragile, Truncal obesity, Round face (moon face), Ecchymosis, Elevated blood pressure, Striae (purple stretch marks), Sugars high (hyperglycemia), Excessive body hair, Dorsocervical fat pad (Buffalo Hump), Depression.

Nursing Interventions

• Prepare for hypophysectomy or adrenalectomy.
• Monitor glucose, potassium, infection, skin breakdown.
• Provide emotional support.

Addison’s Disease

• Hypo secretion of cortisol and aldosterone.
• Mnemonic: Add in, Add some (deals with both hormones).

Causes

• Autoimmune disorder, cancer, tuberculosis, hemorrhage.

Signs & Symptoms (Mnemonic: LOW STEROID)

• Low sugar (hypoglycemia), Low sodium (hyponatremia), Salt cravings, Tired/muscle weakness, Electrolyte imbalances (high potassium, calcium), Reproductive changes, Low blood pressure, Increased pigmentation, Diarrhea and depression.

Nursing Interventions

• Monitor for hypoglycemia, hyperkalemia.
• Replace cortisol (Prednisone, Hydrocortisone).
• Educate on managing stress, medication adherence, and diet.
• Use Medic Alert bracelet.
• Watch for Addisonian crisis.

Addisonian Crisis

• Emergency due to minimal cortisol.
• Five S’s: Sudden pain, Syncope, Shock, Super low BP, Severe vomiting/diarrhea.
• Treatment: IV cortisol (Solu-Cortef), IV fluids (D5 normal saline). Monitor for infection.

• Take related quizzes and explore resources on related endocrine topics for exam preparation.