Cushing’s Syndrome Case Study, Manifestations, and Nursing Implications
Introduction
A 44-year-old male presents with complaints of body malaise and anorexia. He has noticed his attitude going from happy to depressed. He complains of weight gain, bruising easily, and frequent backaches. His arms and legs are thin. He became hypertensive three months ago, he does not have diabetes but his blood sugar has been elevated. His medications include Lisinopril; however, he has been noncompliant.
At the emergency department labs were drawn, his ACTH and urine cortisol were elevated. His sodium was elevated at 150 mEq/L, and potassium was low at 3.0 mEq/L. An MRI revealed a pituitary tumor. He was diagnosed with Cushing’s Syndrome.
Cushing’s Syndrome is serious condition where there is an excess amount of the hormones secreted by the adrenal cortex including glucocorticoids, mineralocorticoids, and gonadocorticoids circulating in the blood (Timby, 2014). This imbalance can be caused by pituitary tumor secreting too much adrenocorticotrophic hormone (ACTH). When there is an excess amount of ACTH secreted by the …show more content…
This is the priority because the patient with Cushing’s disease has thin skin that is very prone to injury. It is so fragile that taking a piece of adhesive tape off may also rip the skin (Nieman, 2013). The skin is the body’s first line of defense, so if the skin is impaired, infection is more likely. The patient with Cushing’s has an impaired immune system and they are at an increased risk to develop opportunistic infections. Due to the immunosuppression, these patients may not manifest with the typical response to infection. Minor changes like a cough, sore throat, wounds that take longer to heal, and a slightly elevated temperature need to be taken seriously (Timby, 2014, p. 853). The long-term goal for this patient is to keep him free from
Introduction
A 44-year-old male presents with complaints of body malaise and anorexia. He has noticed his attitude going from happy to depressed. He complains of weight gain, bruising easily, and frequent backaches. His arms and legs are thin. He became hypertensive three months ago, he does not have diabetes but his blood sugar has been elevated. His medications include Lisinopril; however, he has been noncompliant.
At the emergency department labs were drawn, his ACTH and urine cortisol were elevated. His sodium was elevated at 150 mEq/L, and potassium was low at 3.0 mEq/L. An MRI revealed a pituitary tumor. He was diagnosed with Cushing’s Syndrome.
Cushing’s Syndrome is serious condition where there is an excess amount of the hormones secreted by the adrenal cortex including glucocorticoids, mineralocorticoids, and gonadocorticoids circulating in the blood (Timby, 2014). This imbalance can be caused by pituitary tumor secreting too much adrenocorticotrophic hormone (ACTH). When there is an excess amount of ACTH secreted by the …show more content…
This is the priority because the patient with Cushing’s disease has thin skin that is very prone to injury. It is so fragile that taking a piece of adhesive tape off may also rip the skin (Nieman, 2013). The skin is the body’s first line of defense, so if the skin is impaired, infection is more likely. The patient with Cushing’s has an impaired immune system and they are at an increased risk to develop opportunistic infections. Due to the immunosuppression, these patients may not manifest with the typical response to infection. Minor changes like a cough, sore throat, wounds that take longer to heal, and a slightly elevated temperature need to be taken seriously (Timby, 2014, p. 853). The long-term goal for this patient is to keep him free from