Addison's Disease: NCLEX Priorities

Adrenal insufficiency: fatigue, hyperpigmentation, hyperkalemia, adrenal crisis.

Addison's is primary adrenal insufficiency. NCLEX tests stress dose steroids and adrenal crisis.

Recognition

Fatigue, weight loss, hypotension, hyperpigmentation (ACTH-driven), salt craving, hypoglycemia, hyperkalemia, hyponatremia.

Treatment

Hydrocortisone (glucocorticoid) + fludrocortisone (mineralocorticoid). Lifelong. Medical alert bracelet.

Stress dose

Surgery, illness, trauma → increase steroid dose to mimic stress response. Don't skip.

Adrenal crisis

Severe hypotension, hyperkalemia, hyponatremia, hypoglycemia. IV hydrocortisone 100 mg STAT, fluid resuscitation (NS).

Frequently asked

Primary vs secondary adrenal insufficiency?

Primary (Addison's): adrenal problem. Secondary: pituitary/hypothalamic, no hyperpigmentation, normal aldosterone.

Patient stops steroids abruptly?

Adrenal crisis risk. Lifelong need.

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