Risk for Imbalanced Nutrition — Addison’s Disease Nursing Care Plans

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Common Risk Factors

• Decreased gastrointestinal (GI) enzymes, causing loss of appetite and decreased oral intake tolerance
• Decreased gastric acid production
• Nausea, vomiting, diarrhea

Common Expected Outcomes

• Patient’s nutritional status is optimized as evidenced by maintenance of weight and adequate dietary intake.

Assessment - Risk for Imbalanced Nutrition — Addison’s Disease Nursing Care Plans

• Assess appetite and for the presence of nausea, vomiting, or diarrhea.
  • Cortisol deficit can impair GI function, causing anorexia, nausea, and vomiting
• Monitor trends in weight.
  • This provides documentation of weight loss trends. Weight loss is a common manifestation of adrenal insufficiency.
• Assess foods that patient can tolerate.
  • Appetite may increase with preferred and tolerable foods.
• Monitor serum glucose levels.
  • Patients with adrenal insufficiency are likely to experience hypoglycemia.
• Assess for salt cravings.
  • Aldosterone deficiency causes increased renal excretion of sodium.

Nursing Interventions - Risk for Imbalanced Nutrition — Addison’s Disease Nursing Care Plans

• Encourage high-protein, low-carbohydrate, high-sodium diet.
  • The patient tires because of inadequate production of hepatic glucagon; the recommended diet prevents fatigue, hypoglycemia, and hyponatremia. The patient with primary Addison’s disease needs to increase salt intake 5 g if any activity causes an increase in diaphoresis (e.g., activities in warm weather).
• Suggest need for frequent small meals.
  • Inadequate caloric intake in meals may precipitate hypoglycemia. Promotion of oral intake maintains adequate blood glucose levels and nutrition.
• Encourage rest periods after eating.
  • This is important to facilitate digestion.