Adrenal Crisis Follow-up

Updated: Feb 14, 2018
  • Author: Lisa Kirkland, MD, FACP, FCCM, MSHA; Chief Editor: George T Griffing, MD  more...
  • Print
Follow-up

Further Outpatient Care

See the list below:

  • Treat any underlying or precipitating disorder as clinically indicated.

  • Carefully monitor growth and development in pediatric patients.

  • Recommend medical tag or bracelet that alerts emergency personnel to adrenal gland insufficiency.

  • If exposed to chickenpox, prophylaxis with varicella-zoster immune globulin is indicated.

  • If exposed to measles, prophylaxis with immune globulin is indicated.

  • Closely observe for reactivation of tuberculosis in patients with latent disease.

Next:

Further Inpatient Care

See the list below:

  • Admit to ICU as clinically indicated.

    • Perform fluid resuscitation and hemodynamic monitoring as clinically indicated.

    • Monitor serum electrolytes, magnesium, and glucose every 4-6 hours until stable.

    • Search for precipitating cause of crisis (eg, infection, myocardial infarction, unreported exogenous steroid use within 12 mo, autoimmune disorder).

Previous
Next:

Inpatient & Outpatient Medications

See the list below:

  • Taper steroid dose as outlined previously (see Medication).

Previous
Next:

Complications

See the list below:

  • Immunosuppression

  • Hypertension

  • Salt retention

  • Hypokalemia

  • Weight gain

  • Delayed wound healing

  • Hyperglycemia

  • Metabolic alkalosis

Previous
Next:

Prognosis

See the list below:

  • Prognosis is the same as for patients without adrenal insufficiency if the condition is diagnosed and treated appropriately.

Previous
Next:

Patient Education

See the list below:

  • Instruct patients regarding the importance of careful attention to health and fluid intake and to double maintenance doses when ill until medical attention is obtained.

  • Avoid exposure to chickenpox or measles; if exposed, seek medical advice without delay.

  • Notify physician or seek medical attention for persistent nausea and vomiting, fatigue, and abdominal pain.

  • For excellent patient education materials, see eMedicineHealth's Thyroid & Metabolism Center and patient education article Anatomy of the Endocrine System.

Previous