Cushing's disease

Question 1

What can cause Cushing’s disease?

Answer 1

Problems with hypothalamus and pituitary
Long time administration of glucosteriods (asthma, chemo, cystic fibrosis)
Adrenal tumor

Question 2

Lab values of Cushing’s disease

Answer 2

Hyperglycemia
Hypernatremia
Hypokalemia
Decrease eosinophils

Question 3

Diagnostic tests for Cushing’s

Answer 3

ACTH test
Serum cortisol levels
Salivary test at night
24 hour urine test

Question 4

Treatment for Cushings

Answer 4

Surgical removal of pituitary gland or adrenal tumor
Radiation
Slowly wean off steriods
Drug control causing Cushing-like symptoms

Question 5

Nursing care of Cushing’s

Answer 5

Obtain H&;P, assess muscle weakness/pain, assist with ambulation and ADLs, assess skin, assess CV and pulmonary, monitor for FVO, monitor I&O, monitor Blood sugar and other lab values, monitor for signs of infection, monitor mental status

Question 6

Patient education

Answer 6

Teach patient about the disease, their medications and adverse reactions, the importance of keeping appointments, wear Med alert bracelet

Question 7

Cushing’s Disease is insufficiency or the over production of cortisol?

Answer 7

Overproduction

Question 8

Priority problems with cushings disease

Answer 8

Fluid overload
Risk for infection 
Knowledge Deficit
Risk for injury 
Body image

Question 9

Manifestations of cushings

Answer 9

Moon face
Buffalo hump
Stretch marks
Thin skin
Acne 
Very hairy 
Slow to heal 
Amenorrhea

Question 10

What is Aminogluthimide (Cytadren)

Answer 10

Treatment for Cushing syndrome
SE: effects cholesterol, jaundice, hypotension, skin lesions, liver toxicity
Nursing Implications: take with food, gives hypotension

Question 11

What is ketaconazole

Answer 11

First choice treatment for cushings
Fungal treatment
Can cause liver insufficiency