The commonest cause of primary adrenal failure and shrunken adrenals is autoimmune adrenalitis. The same clinical picture with adrenal masses is nowadays most commonly due to carcinomatous spread. Our case emphasizes the importance of obtaining tissue from patients such as these, where no primary lesion is apparent, as occasionally a treatable lymphoma will be found.

The nurse has the opportunity to improve care for women who lost their mothers before the age of 18 years. During pregnancy, childbirth, and childrearing, the woman may feel sad and anxious without the guidance of her mother. Special ways of caring may be instituted to provide her comfort such as allowing and encouraging her to bring a special item of her mother's to procedures and events so that she may feel connected with her, allowing someone to stand in for her mother, perhaps assisting in finding of another motherless child adult to be with her as needed, and the voicing of understanding of her loss while remaining nonjudgmental about her emotions during these times.