by Woman_in_love

Hi guys!
Im studying for my NCLEX-RN test and i found the issue of Cushing syndrome and Addison disease very confusing.
IS hyperkalemia occurs in Addison disease?
Because i remember that high blood pressure and elevated sodium levels-is about Cushing syndrome.
Welp, its confusing. Could you help me out with that please?
Thanks a lot

Cushing's/Addison's

Originally Posted by Woman_in_love

Hi guys!
Im studying for my NCLEX-RN test and i found the issue of Cushing syndrome and Addison disease very confusing.
IS hyperkalemia occurs in Addison disease? YES
Because i remember that high blood pressure and elevated sodium levels-is about Cushing syndrome.
Welp, its confusing. Could you help me out with that please?
Thanks a lot

Cushings Patho:

Increased cortisol -> Increased gluconeogenisis -> hyperglycemia

Increased aldosterone -> sodium and water retention, potassium loss

Addison's patho:

decreased cortisol -> decreased gluconeogenesis -> hypoglycemia

decreased aldosterone -> sodium and water loss, potassium retention

This is from my school notes...hope it helps

Chickey

Originally Posted by rn_chickey

Cushings Patho:

Increased cortisol -> Increased gluconeogenisis -> hyperglycemia

Increased aldosterone -> sodium and water retention, potassium loss

Addison's patho:

decreased cortisol -> decreased gluconeogenesis -> hypoglycemia

decreased aldosterone -> sodium and water loss, potassium retention

This is from my school notes...hope it helps

Chickey

It sure does!
Thank you so much, i guess the answer in my book was wrong which confused me. It said that in Cushing syndrome patient will have a hyperkalemia. Bums!

Which book were you using?

Originally Posted by suzanne4

Which book were you using?

Its CD from the book Saunder's "Comprehensive review for the NCLEX-RN" examination" by L.A.Silvestri.
I like this book but i guess as a human beings they do mistakes sometimes.
There was a question like this
What would you expect in client with Cushing syndrome.
1)Glucose 110 mg/dl
2) White cells-6000
3)Platelets-200000
4)Potassium-5.5

I answered the glucose thing and CD answer was potassium-5.5

I would have gone with the potassium also. In Cushings, and because of the steroid use, the glucose level is going to be much higher.....usually in the 250 to 300 range during an acute episode.

What exactly did the book say?

I keep Cushing's and Addison's straight this way:

I just remember that they are both diseases caused by hypo- or hypersecretion of the Adrenal gland. If you remember that the adrenal gland secretes corticocorticoids (I always think "sugar") and mineralcorticoids (I think "salt"), you can pretty much figure out the two diseases of Cushing's and Addison's.

Just remember: Cushing's=HYPERsecretion=hyperglycemia (increased sugar), hypernatremia (increased salt) so therefore--hypokalemia, hypocalcemia

Addison's=HYPOsecretion=hypoglycemia (low sugar), hyponatremia (low salt), so therefore = hyperkalemia, hypercalcemia

Once you remember these ups and downs of the two diseases, you can pretty much figure out the disease symptoms. You also have to remember that the adrenal gland also produces androgens (sex hormones) which leads to hirsutism (male and female) and male pattern baldness (females) in Cushing's.

I take the test tomorrow morning at 9 and those are basically the only two diseases I feel good about! Now ask me a question about meds and I'm toast.
Good luck on the test!

Then why hyperkalemia is the right answer?

oh yeah....endocrinology...my favorite (NOT). I still get confused. I'm going to copy some of these into my notes.

Delegating care

Hi everyone!
I wanted to know who's responsibility it's gonna be when RN delegates care to a nursing assistant or LPN and the mistake in care happens.
I remember that there is some type of delegation when RN is responsible and some type when the LPN/CNA will be held responsible.
Can anyone explain this to me please?
I guess those things do show up in NCLEX-RN, so i better know them
Thanks