ebb phase
flight response
unchanged metabolism
body temp deceased
o2 consumption decreased
glucose-increased
lactate-increased
furl-glucose/fat
flow
fight response
hypercatabolic
hypermetabolic
increased temp
increased o2 comsumption
glucose-increased
lactate-increased
fuel source-fat/glucose/ amino acids/ lean muscle
adrenal insuffiency
primary
secondary
- Primary: inability of the gland to secrete cortisol or aldosterone
- Secondary: inability of the HPA to release ACTH
adrenal insufficiency s/s
fever
tachycardia
orthostatic hypotension
hypotension- not responsive to vaso
aneroxic
hyperkalemia
hypo na
hypoglycemia
acidosis
increased BUN
weak
adrenal insuff. dx
rapid acth
going to see how adrenal respond to acth
supposed to increase cortisol levels
- Do ABGs before and Allen Test
- Plasma ACTH levels from aterial
- ACTH (250mcg) given IV or IM
- Second plasma level drawn 60-90mins later
- Low = secondary adrenal
adrenal insuff TX.
hydrocortisone
weight bearing exercises
JUST DONT STOP MED
increased risk for infections
hyperthyroid/hypo thyoid not covered too easy
...
Non thyoid illness syndrome
decreased t3
normal t4/tsh
not responsive to thyroid hormone
hyperglycemia tx
DKA /HHS
� Restore fluid and electrolyte balance
� IV insulin
� Maintain glucose level of 140-180mg/dL
� Identify causative factors