Addison Disease (Primary Adrenal Insufficiency)

Addison disease is primary adrenal insufficiency: failure of the adrenal cortex removes both cortisol and aldosterone production. Cortisol deficiency weakens vascular tone and the response to physiological stress; aldosterone deficiency causes renal sodium loss, potassium retention, and volume depletion. The resulting picture may resemble gastroenteritis, sepsis, or an acute abdomen until hypotension, electrolyte abnormalities, and other characteristic findings are recognized together. The immediate nursing question is whether adrenal crisis is developing. If it is suspected, hydrocortisone and 0.9% sodium chloride begin at once; baseline cortisol and ACTH samples are obtained alongside treatment, not instead of it.