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Cushings syndrome
pn 141 test 1 Book: med surg nursing pg 348
| Question | Answer |
|---|---|
| def of cushings syndrome | chronic disorder in which the adrenal cortex produces excessive amounts of the hormone cortisol |
| is there an high amounts of cortisol or low amounts | high amounts |
| who does is occur most in | women between ages 20 and 50 |
| how can adrenal tumors cause cushings | it can increase the production of cortisol |
| how can a tumor of the pituitary gland cause cushings | this tumor can increase adrenocorticotropic hormone (ACTH) release, which stimulates the adrenal cortex to produce cortisol |
| how can lung or pancreatic tumors cause cushings | they can increase the ACTH production |
| why does increased glucocorticoid therapy cause cushings | cushings is the side affect from prolonged steroid use |
| the adrenal cortex secretes what two hormones | cortisol and aldosterone |
| what are the changes in fat metabolism | fat deposits in the abdomen, fat pads under the clavicle, buffalo hump over the upper back, and a round moon face |
| muscle weakness and wasting in the exremities is caused by what | altered protein metabolism |
| altered glucose metabolism causes what | DM |
| what happens to the skin | it thins; striae occurs when the skin stretches over the abdomen and buttocks |
| decreased calcium absorption results in what | osteoporosis and compression fractures of the vertebrea |
| when mineralocorticoid are released, what happens to sodium and what happens to potassium | sodium and water is retained, and potassium is lossed leading to HTN |
| Untreated cushings can lead to what | hypernatremia, hypokalemia, hyperglycemia, HTN, heart failure |
| why are severe infections life threatening | increased cortisol suppresses immunity |
| what is the most common tx | surgery |
| typres of treatments | medication, diet surgery |
| what diagnostic tests will reveal cushings yndrome | elevated cortisol and a 24 hour urine test that is positive for ketosteroids and hyrdroxycorticosteroids |
| Will plasma ACTH be elavated or low | elevated |
| what type of pt will be more often treated with meds then surgery | cushings caused by an inoperable pituitary or adrenal tumor |
| can the drugs cure the disorder | no; only control s/s |
| two commonly prescribed drugs | mitotane (Lysodren), metyrapone/ aminoglutethimide (cytadren) |
| what does the med mitotane (Lysdren) do | it suppresses activity of the adrenal cortex |
| what does the med mitotane metyrapone/ aminoglutethimide (cytadren) do | it inhibits cortisol synthesisby the adrenal cortex |
| what are side effects of the meds | decreased adrenal function, anorexia, nausea, vomiting, diarrhea, hypotension, tachycardia |
| what is an adrenalectomy | removel of the adrenal cortex |
| what is the tx for cushing's causes by an adrenal cortex tumor | an adrenalectomy |
| what is needed lifelong if a bilateral adrenalectomy is done | lifelong corticosteroid and mineralcorticoid replacement therapy |
| with a bilateral adrenalectomy, why is the patient placed in the icu | because of their high risk for addison's crisis(aka adrenal crisis) |
| what type of pt is radiation therapy needed for | for the client with an inoperable pituitary tumor |
| what are the most common problems for people with cushing's syndrome | fluid and electrolyte balance, injury, infection, and body image |
| what causes excess flui volume for a person with cushings | excess cortisol secretion causes sodium and ater retention which leads to fluid volume excess and weight gain. |
| why should fluids be limited | to decrease th risk for fluid overload related to the increased sodium and water retention |
| since cushings decreases the inflammatory response, pt don't show normal s/s of an infection. What might be their first indicater of infection | temp change, pulse |
| why is wound healing delayed | it is delayed because excess cortisol decreases protein synthesis |
| why do people with cushings have a greater risk for impaired skin integrity | b/c these people have frail thin skin |
| what should their diet be | high in potassium, low in sodium, cals and carbs |
| what is the mineralcorticoids | aldosterone |
| is cortisol high or low | high |
| function of cortisol: what does it respond to | stress |
| function of cortisol: what does it do | responds to stress, maintain BP and CV function, balance effect of Insulin and breakdown of sugar, regulates breakdown protein CHO, fats; maintains arousal ability |
| what does ACTH do | it comes from the pituitary and acts on the adrenal glands and tells it to release cortisal |
| so if ACTH is super low; is cortisol high or low | it is high |
| what is the function of aldosterone | maintain fluid balance, BP, helps kidneys retain Na and excrete k+ |
| what is hirsutism | hair in places they don't want |
| Tx: | surgery, radiation, suppress adrenocortical function, limit, decrease dose of corticosteroids |
Created by:
jmkettel
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