DAVISS COMPREHENSIVE HANDBOOK OF LABORATORY & DIAGNOSTIC WITH NURSING IMPLICATIONS 6TH EDITION (TEXTBOOK)

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Observe/assess the patient who has been administered metyrapone for signs and symptoms of an acute adrenal (addisonian) crisis which may include abdominal pain, nausea, vomiting, hypotension, tachycardia, tachypnia, dehydration, excessively increased perspiration of the face and hands, sudden and significant fatigue or weakness, confusion, loss of consciousness, shock, coma. Potential interventions include immediate corticosteroid replacement (IV or IM), airway protection and maintenance, administration of dextrose for hypoglycemia, correction of electrolyte imbalance, and rehydration with IV fluids. ➧➧ Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. If a diagnosis of Cushing’s disease is made, pituitary computed tomography (CT) or magnetic resonance imaging (MRI) may be indicated prior to surgery. If a diagnosis of ectopic corticotropin syndrome is made, abdominal CT or MRI may be indicated prior to surgery. Evaluate test results in relation to the patient’s symptoms and other tests performed. Patient Education: ➧➧ Instruct the patient to resume normal activity as directed by the HCP. ➧➧ Provide contact information, if desired, for the Cushing’s Support and Research Foundation (www.csrf.net). ➧➧ Reinforce information given by the patient’s HCP regarding further

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