A 39-year-old construction worker who complains of decreased energy, impotence, and abdominal pain is being tested for Addison disease.

What data should the nurse collect when obtaining the patient's health history? What physiologic changes in the body result in the abnormal symptoms of Addison disease?"

In the process of diagnosing and managing a patient with Addison disease who is a 39-year-old construction worker patient’s health history should be taken seriously. Here’s what the nurse should focus on when collecting data and understanding the physiological changes involved:

 Health History Data Collection

 Symptom Assessment

 Energy Levels: How useful is it to discuss the onset, duration, and degree of low energy?

 Sexual Function: Explain the type of impotence – whether it is ‘strict’ or ‘global,’ and whether it is associated with any symptoms or their duration.

 Abdominal Pain: Ask about the spatial and temporal distribution of the pain, the color, and volume of vomiting, and the nature of the abdominal pain.

 Medical History

 Chronic Illnesses: Information about autoimmune diseases, infections or some other chronic diseases, if any.

 Medication Use: When performing the DEXA test, always document the use of any current or recent medications especially corticosteroid which will affect the adrenal gland.

 Family History

 Autoimmune Diseases: Ensure you understand any history of autoimmune diseases like thyroiditis or Type 1 diabetes which are link with Addison disease.

 Lifestyle and Occupational History

 Work Environment: Depending on the job the patient is engaged in, evaluate if there are stressors or conditions that can impact on general health.

 Stress Levels: Consider also brief recent or present physical or emotional stress which the patient experienced as it can worsen adrenal insufficiency.

 Previous Diagnoses and Treatments

 Adrenal Issues: Part or medical history, notably if you have ever been diagnosed with or treated for adrenal or endocrine conditions.

 Psychological Well-being

 Mood Changes: Screen for signs and symptoms that are common with depression and irritability because they are related to Addison disease.

 Hygienic Alterations in Addison Disease

 Adrenal insufficiency in the adult refers to a condition in which the adrenal glands do not produce sufficient hormones for the body’s needs; it is also known as Addison disease. The physiological changes that lead to the symptoms include:The physiological changes that lead to the symptoms include:

 Decreased Cortisol Production

 Effect: Cortisol is involved in energy metabolism and regulation, immune response and acts as an anti-inflammatory agent. Low levels of cortisol cause tiredness, muscle wasting and weakness as well as low energy levels. This hormone also affects sexual behaviour in that it leads to impotence in some cases.

 Decreased Aldosterone Production

 Effect: Aldosterone is involved with sodium and potassium homeostasis as well as control of fluid volume in the body. Aldosterone is involved in the regulation of sodium and potassium, thus, low levels result to hypotension, dehydration, abdominal pain as related to electrolyte imbalance.

 Hyperpigmentation

 Effect: Lack of cortisol feedback inhibition to the pituitary gland results in high levels of adrenocorticotropic hormone (ACTH) and melanocyte activation in the skin, and hyperpigmentation especially to frayed parts.

 Electrolyte Imbalances

 Effect: The low levels of aldosterone affects sodium and potassium and has symptoms such as stomach ache, vomiting, nausea, and low blood pressure.

 Increased Stress Response

 Effect: Low levels of cortisol in the body leads to the failure of the body to respond effectively to stress that may be physical or psychological making the patient feel more tired and weak.

 Summary

 In diagnosing a patient that might have Addison disease, the nurse should take details history of features, medical/ family background, lifestyle, and psychological state. These alterations of the steroid hormones Cortisol and Aldosterone are behind Addison diseases signs and symptoms which include; low energy, impotence and abdominal pain among others. Knowledge of such alterations forms the basis for proper testing and treatment.