In clinical settings, some of the most common questions that patients ask are Why do I have
this? What caused this disorder? Will it ever go away? These emotional questions can be
difficult to ask and to answer. However, for patients to come to terms with their diagnoses
and adhere to treatment plans, they must have an understanding of factors that might have
caused, or continue to impact, their disorders. As an advanced practice nurse, it is
important that you are able to explain disorders, associated alterations and symptoms, and
changes that might occur within your patients’ bodies.
�Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the
importance of developing an in-depth understanding of pathophysiology.
�Select a disorder from the following list:
Adrenal insufficiency (Addison’s disease)
Nephrolithiasis (kidney stones)
�Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior.
Reflect on how that factor might impact your selected disorder, as well as potential
associated alterations and symptoms.
�Identify the pathophysiology of the associated alterations, including the normal and
altered cellular function. Consider both intra- and extra-cellular changes that occur.
Post on or before Day 3 a brief description of a patient scenario involving the disorder and
the factor you selected. Explain how the factor might impact your selected disorder, as well
as potential associated alterations and symptoms. Finally, explain the pathophysiology of
the associated alterations, including changes in cellular function.
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate
custom ed.). St. Louis, MO: Mosby.
McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to
clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill
Factors that Influence Disease: Addison’s Disease
According to Khardori (2014), destruction of glucocorticoid and mineralocorticoid as a
result of autoimmunity, leads to under-production of adrenaline. This in turn, causes Addison’s
disease. Immune system may mistakenly produce self-antagonizing antibodies; adrenal cortex
FACTORS THAT INFLUENCE DISEASE: ADDISON’S DISEASE 2
cells are, hence, steadily damaged (Margulies, 2014). Some researchers (geneticists) indicate that
it is polygenic inheritance that is a prerequisite for genetic predisposition. Rothhard (2012), in his
work, postulates that this disorder could be X-linked and mostly affects male children.
Associated alterations are disorders such as Schmidt’s syndrome that manifests in case of
coexistence of Addison’s disease and hypothyroidism. Others may include rare insulin dependent
diabetes mellitus, hyperparathyroidism, and pernicious anemia. (Margulies, 2014; McPhee,
2012). Moreover, associated symptoms may include nausea, vomiting, and diarrhea, as well as
weight loss (2014). Furthermore, extreme pigmentation on ‘the sun-exposed areas of the skin’ is
as well, manifested.
Pathophysiology has been used to refer to reported deficiency of adrenocortical levels as
a result of dysfunctional adrenal cortex. (Khardori, 2014 and Huether, 2012). The disease
culminates usually in cases where 90% of the cortices are malfunctioned. This in turn, negatively
impacts on the glucocorticoid and mineralocorticoid function. (Kardori, 2014).
Cellular effects include low blood pressure and decreased Na + levels due to insufficient
secretion of aldosterone, which facilitates absorption of sodium ions. Dehydration occurs where
too much intake of water is tenable. Huether (2012) terms pathophysiology as an intact case that
delves into the Addisonian crisis. Symptoms of water intoxication are also evident. An
extracellular hypotonic condition exists where water moves into the cell via osmosis, as resulting
effects of hyponatremia (McPhee, 2012).
FACTORS THAT INFLUENCE DISEASE: ADDISON’S DISEASE 3
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate customed.).
St. Louis, MO: Mosby.
McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to clinical
medicine (Laureate Education, Inc., customed.). New York, NY: McGraw-Hill Medical
FACTORS THAT INFLUENCE DISEASE: ADDISON’S DISEASE