Juanita is a 33yearold female patient who was recently diagnosed with Addison’s

Juanita is a 33-year-old female patient who was recently diagnosed with Addison’s disease. The patient is experiencing darkening of the skin, hypernatremia, and depression.OTHER PERTINENT INFORMATIONWeight – 175 poundsHeight – 6 feet and 3 inches tallTemperature – 98.5 degrees Fahrenheit1. Convert Juanita’s weight into kg, height into centimeters and temperature into Celcius.175/2.2=79.54190.5 cms(98.5°F − 32) × 5/9 = 36.944°C(98.5°C × 9/5) + 32 = 209.3°F2. What initial medication management will the nurse expect to administer? Hormone replacement therapy is used to substitute the lost hormones on patients with Addison’s disease (Mayo Clinic, 2018). The patient should be given Hydrocortisone, prednisone or methylprednisolone to replace cortisol. and Fludrocortisone acetate to replace aldosterone aldosterone is replaced with oral doses of a mineralocorticoid (Mayo Clinic, 2018).3. What adverse effects are related to the drug fludrocortisone? Fludrocortisone is a mineralocorticoid that can affect various body systems (Lilley, Collins, & Snyder, 2017). If the organ is being affected by the adrenocortical hormone it can be affected by the medication. Its adverse effects are water retention, that leads to heart failure, hypertension and increased intracerebral pressure. Other adverse effects includes: skin rash, peptic ulcer, muscle pain, fractures, menstrual irregularities, hyperglycemia, hypokalemia and etc. (Lilley et al., 2017)4. What teaching would the nurse provide to the patient about fludrocortisone? Patient teaching would include taking fludrocortisone with antacids since it can cause gastric ulcers (Lilley et al., 2017). The antacid would protect the stomach lining. Motoring of daily weight. fludrocortisone influences fluids and weight is a tool to monitor changes. A loss or gain of 3 lbs or more should be reported. High protein and carbohydrate diet should be provided to maintain intravascular volume sufficiency. Advise the patient to contact healthcare providers when she feels weak, confused and when blood pressure drops. This are signs or vascular collapse. Advise the patient to contact healthcare professionals when the patient has symptoms of infections. fludrocortisone can hide symptoms of it and can cause death to immunocompromised patient (Lilley et al., 2017). 5. What drugs have significant interactions with fludrocortisone? Fungal infection drug such as amphotericin B, combined with fludrocortisone can cause hypokalemia (Healthline, 2019). Which can cause muscle pain and weakness and dysrhythmias. Combining fludrocortisone and furosimide can also cause hypokalemia. “Combining digoxin with fludrocortisone can increase your risk of irregular heartbeat””. Combining Nonsteroidal anti-inflammatory drugs (NSAIDs) with fludrocortisone can cause the NSAID not to work. It places the patient at risk for stomach and intestinal side effects. Fludrocortisone decreases the actions of drugs that acts on diabetes. “”Taking phenobarbital with fludrocortisone may decrease levels of fludrocortisone in your blood””. Ask for medical advice for increasing dosages of fludrocortisone. This is also applicable for antibiotics such as rifampin combined with fludrocortisone. As well as taking phenytoin with fludrocortisone. Male hormones (anabolic steroids) can increase swelling. When taking estrogens with fludrocortisone can increase the amount of fludrocortisone in your blood. The doctor needs to decrease fludrocortisone dosage (Healthline

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