Nursing Considerations
After successful surgical excision of adrenal or pituitary
adenoma, there is a period of adrenal insufficiency while the
hypothalamic–pituitary–adrenal axis recovers function.
During this period, replacement with GC (physiologic dose
of 10–12 mg/m2/day) and “sick-day” stress dosing should be
maintained. Patients who undergo bilateral adrenalectomy
require lifetime replacement with GC and mineralocortoid
(fludrocortisone), as well as stress dosing for acute illness,
trauma, or surgical procedures (Lodish, Dunn, Sinaii, Keil, &
Stratakis, 2012) (see Links to Resources below).