adrenal crisis


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Related to adrenal crisis: Adrenal insufficiency, Adrenal fatigue

crisis

 [kri´sis] (pl. cri´ses) (L.)
1. the turning point of a disease for better or worse; especially a sudden change, usually for the better, in the course of an acute disease.
2. a sudden paroxysmal intensification of symptoms in the course of a disease.
addisonian crisis (adrenal crisis) the symptoms accompanying an acute onset or worsening of addison's disease: anorexia, vomiting, abdominal pain, apathy, confusion, extreme weakness, and hypotension; if untreated these progress to shock and then death.
aplastic crisis a sickle cell crisis in which there is temporary bone marrow aplasia.
blast crisis a sudden, severe change in the course of chronic granulocytic leukemia, characterized by an increased number of blasts, i.e., myeloblasts or lymphoblasts.
catathymic crisis an isolated, nonrepetitive act of violence that develops as a result of intolerable tension.
celiac crisis an attack of severe watery diarrhea and vomiting producing dehydration and acidosis, sometimes occurring in infants with celiac disease.
developmental crisis maturational crisis.
hemolytic crisis an uncommon sickle cell crisis in which there is acute red blood cell destruction with jaundice.
hypertensive crisis dangerously high blood pressure of acute onset.
identity crisis a period in the psychosocial development of an individual, usually occurring during adolescence, manifested by a loss of the sense of the sameness and historical continuity of one's self, confusion over values, or an inability to accept the role the individual perceives as being expected by society.
life crisis a period of disorganization that occurs when a person meets an obstacle to an important life goal, such as the sudden death of a family member, a difficult family conflict, an incident of domestic violence (spouse or child abuse), a serious accident, loss of a limb, loss of a job, or rape or attempted rape.
maturational crisis a life crisis in which usual coping mechanisms are inadequate in dealing with a stress common to a particular stage in the life cycle or with stress caused by a transition from one stage to another. Called also developmental crisis.
myasthenic crisis the sudden development of dyspnea requiring respiratory support in myasthenia gravis; the crisis is usually transient, lasting several days, and accompanied by fever.
oculogyric crisis a symptom of an acute dystonic reaction in which the person demonstrates a fixed gaze, usually upward; also, the uncontrollable rolling upwards of the eye. It can be a result of encephalitis or a reaction to antipsychotic medications.
salt-losing crisis see salt-losing crisis.
sickle cell crisis see sickle cell crisis.
tabetic crisis a painful paroxysm occurring in tabes dorsalis.
thyroid crisis (thyrotoxic crisis) see thyroid crisis.
vaso-occlusive crisis a sickle cell crisis in which there is severe pain due to infarctions in the bones, joints, lungs, liver, spleen, kidney, eye, or central nervous system.

a·cute a·dre·no·cor·ti·cal in·suf·fi·cien·cy

severe adrenocortical insufficiency when an intercurrent illness or trauma causes an increased demand for adrenocortical hormones in a patient with adrenal insufficiency resulting from disease or use of relatively large amounts of similar hormones as therapy; characterized by nausea, vomiting, hypotension, and frequently hyperthemia, hyponatremia, hyperkalemia, and hypoglycemia; can be fatal if untreated. Death results from fulminant inflammation and/or circulatory collapses (that is, shock).

adrenal crisis

an acute, life-threatening state of profound adrenocortical insufficiency in which immediate therapy is required. It is characterized by glucocorticoid deficiency, a drop in extracellular fluid volume, and hyperkalemia. Also called crisis. See also Addison's disease, adrenal cortex.
observations Typically, the patient appears to be in shock or coma with a low blood pressure, weakness, and loss of vasomotor tone. The person's medical history may include abrupt discontinuation of exogenous steroids or Addison's disease or reveal symptoms indicating its presence. Results of laboratory tests show hyperkalemia and hyponatremia.
interventions An IV isotonic solution of sodium chloride containing a water-soluble glucocorticoid is administered rapidly. Vasopressor agents may be necessary to combat hypotension. If the patient is vomiting, a nasogastric tube is inserted to prevent aspiration and relieve hyperemesis. Total bed rest and monitoring of blood pressure, temperature, and other vital signs are mandatory. After the first critical hours, the patient is followed as for Addison's disease, and corticosteroid dosage is tapered to maintenance levels. Infection and a failure to increase the maintenance glucocorticoid (steroid) dose are common causes of crisis in people who have Addison's disease.
nursing considerations Nursing care during adrenal crisis includes eliminating all forms of stimuli, especially loud noises or bright lights. The patient is not moved unless absolutely necessary and is not allowed to perform self-care activities. If the condition is identified and treated promptly, the prognosis is good. Discharge instructions include a reminder to the patient to seek medical attention in any stressful situation, whether physiological or psychological, to prevent a recurrence of the crisis.

Acute Adrenal Crisis

Acute life-threatening adrenocortical insufficiency with markedly reduced serum cortisol, which arises in a background of chronic adrenocortical insufficiency (Addison’s disease).  
Aetiology Infections, trauma, adrenal haemorrhage, tuberculosis, surgery, dehydration with salt deprivation, destruction of pituitary gland or evoked by replacing thyroid hormone in patients with hypothyroidism of hypothalamic or pituitary origin and underlying mild ACTH deficiency.
Triggers GI infection, fever
Clinical findings Hypotension, shock, fever, dehydration, anorexia, weakness, apathy, headache, vomiting, chills, tachycardia, sweating, abdominal pain
Lab Reduced Na+, increased K+, increased white cells, eosinophilia, hypoglycaemia
Management Pharmacologic doses of IV hydrocortisone, pressor support

adrenal crisis

Addisonian crisis, acute adrenal insufficiency Endocrinology Acute life-threatening adrenocortical insufficiency with ↓ serum cortisol, seen in Pts with Addison's disease Triggers Infections, trauma, hemorrhage, TB, surgery, dehydration with salt deprivation, destruction of pituitary gland or evoked by replacing thyroid hormone in Pts with hypothyroidism of hypothalamic or pituitary origin and underlying mild ACTH deficiency Clinical Hypotension, shock, fever, dehydration, anorexia, weakness, apathy, headache, vomiting, chills, tachycardia, sweating Lab ↓ Na+, ↑ K+, ↑ WBCs, eosinophilia, hypoglycemia Management Pharmacologic doses of IV hydrocortisone, BP support.

a·cute a·dre·no·cor·ti·cal in·suf·fi·ci·en·cy

(ă-kyūt' ă-drē'nō-kōr'ti-kăl in'sŭ-fish'ĕn-sē)
Sudden worsening of signs and symptoms of corticosteroid deficiency when trauma or illness causes increased demand in a patient with impaired adrenal insufficiency.
Synonym(s): addisonian crisis, adrenal crisis.

adrenal crisis,

crisis

pl. crises [L.]
1. the turning point of a disease for better or worse; especially a sudden change, usually for the better, in the course of an acute disease.
2. a sudden paroxysmal intensification of signs in the course of a disease.

addisonian crisis
signs of severe depression, muscle weakness, vomiting and diarrhea accompanying an acute attack of adrenocortical insufficiency (Addison's disease). Called also adrenal crisis.
adrenal crisis
see addisonian crisis (above).
References in periodicals archive ?
The salt-losing type of CAH presents with adrenal crisis a few weeks after birth, while the simple type manifests virilisation and rapid growth years later.
DNA analysis therefore allows early identification of those patients at risk for an adrenal crisis that could be prevented with glucocorticoid replacement.
Our founder has experienced the uncertainty of continued survival through such events and symptoms including hypovolemic shock, adrenal crisis, collapses at home pre-diagnosis, uncontrollable vomiting and diarrhea, hypotension, dizziness, intolerance to cold, muscle pain and aches, darkening of the skin, mouth sores and intense salt cravings to name some.
Salt-wasting classical CAH must be detected at birth to avoid adrenal crisis, which can lead to death.