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Cushing Syndrome Handout SP2024

Cushing Syndrome is characterized by excessive adrenocortical activity, primarily affecting glucocorticoids and androgens, leading to various symptoms such as hypertension, obesity, and mood changes. Pheochromocytoma, a tumor of the adrenal medulla, can cause severe hypertension if untreated, and diagnosis involves assessing catecholamine levels and clinical manifestations. Treatment options include medication, surgical intervention, and lifestyle modifications to normalize hormone secretion and manage complications.

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32 views1 page

Cushing Syndrome Handout SP2024

Cushing Syndrome is characterized by excessive adrenocortical activity, primarily affecting glucocorticoids and androgens, leading to various symptoms such as hypertension, obesity, and mood changes. Pheochromocytoma, a tumor of the adrenal medulla, can cause severe hypertension if untreated, and diagnosis involves assessing catecholamine levels and clinical manifestations. Treatment options include medication, surgical intervention, and lifestyle modifications to normalize hormone secretion and manage complications.

Uploaded by

beattyi991.ecc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Cushing Syndrome

Pheochromocytoma Assessment Data/Clinical Manifestations/Cues


Excessive adrenocortical activity Multiple symptoms affecting every system
Mostly affects glucocorticoids & Tumor of adrenal medulla (usually benign) that
causes HTN which is fatal if untreated - Abdominal fat deposits: Buffalo hump, moonface, truncal
androgens; minimal effect on obesity/thin extremities
mineralocorticoids Diagnosis: 5 H’s: HTN, headache, hyperhidrosis,
hypermetabolism, hyperglycemia ↑ sodium
Urine & plasma levels of catecholamines ↑ glucose
Cushing Disease – tumor related ↓ potassium
Tx: BP meds, surgical removal of tumor
-
Nursing Assessment

- S&S Who is at risk? - Causes


- Medications
- Level of activity - Use of exogenous corticosteroid
- Skin - Pituitary Gland tumor Collaborative Interventions (Actions)
- Response to changes in - Primary hyperplasia of the adrenal
appearance glands
- Mood, depression - Ectopic production of ACTH by
Goal: Normalize Hormone Secretion
- Sexual Lx: libido, amenorrhea malignancies – Bronchogenic Ca
- Treatment depends on cause
- Labs
- Taper steroids dose – alternate day therapy
- Infection
- Transsphenoidal Hypophysectomy or radiation if
- Pt. Problems: Excess fluid volume
Pituitary Tumor
Knowledge deficit
Relevant Clinical Data Post-op Care

Serum Cortisol
Complications Anticipated - Adrenalectomy: single or bilateral
- High in AM
Post-op Care
- Low in PM
- Variation lost with Cushing’s
- Addisonian Crisis 24-hour Urine Cortisol Level
- HF - Adrenal Enzyme Inhibitors if caused by ectopic ACTH
- Normal: 80-120mcg in 24 hours
- HTN Production
- +Result: 3x upper limit of normal
- Diabetes: check BG - Blood glucose monitoring & Hypoglycemic agents
Dexamethasone Suppression Test
- Peptic ulcers: check stool - Diet: High protein, low carbs, low Na, High Ca and
- Decadron 1mg or 8 mg at bed
Vitamin D
- Plasma cortisol level drawn at 8am
- Avoid exposure to infection
- Suppression of cortisol level to
- Activity: encourage with rest period
<5mg/dL indicates HPA axis is
- Skin Integrity
working
- FE Status: Daily wts, labs, I&O
- Na Increase, K+ Decrease, Glucose
- Emotional support- self-image
Increase
- CT/MRI

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