Medsurg Final 3

Question 1

Cushing’s disease and Cushing’s syndrome are caused by an

Answer 1

oversecretion of the adrenal cortex

Question 2

Cushing’s disease is caused

Answer 2

directly by oversecretion of the adrenal cortex

Question 3

Cushing’s syndrome is caused by

Answer 3

long-term use of glucocorticoids to treat other conditions, such as asthma or RA

Question 4

affects glucose, protein, and fat metabolism; the body’s response to stress; and the body’s immune function

Answer 4

Glucocorticoids, like Cortisol

Question 5

increases sodium absorption, causes potassium excretion in

the kidney

Answer 5

Mineralocorticoids, like Aldosterone

Question 6

Cushing’s: Advise the client that medication therapy may be

Answer 6

lifelong

Question 7

Cushing’s: Advise the client to eat foods high in

Answer 7

calcium and vitamin D

Question 8

Cushing’s: The client should not use ___ or ___

Answer 8

alcohol or caffeine

Question 9

Cushing’s: teaching: client should watch out for

Answer 9

GI bleeding

Question 10

Cushing’s: Manifestations: Altered emotional state (may include ___ or ___)

Answer 10

irritability or depression

Question 11

Cushing’s: Manifestations: Skin

Answer 11

Thin and fragile

Question 12

Cushing’s: Manifestations: ___ ulcers

Answer 12

Gastric

Question 13

Cushing’s: Manifestations: ___ edema

Answer 13

dependent edema

Question 14

Cushing’s: Manifestations: hair

Answer 14

Hirsutism

Question 15

____ cortisol levels are used to confirm the diagnosis of Cushing’s disease

Answer 15

Salivary

Question 16

Dexamethasone suppression tests: _____ of cortisol excretion is indicative of Cushing’s disease

Answer 16

Nonsuppression

Question 17

Dexamethasone suppression tests for Cushings: False positive results may occur in clients with acute illness and

Answer 17

alcoholism

Question 18

Cushing’s: Dietary alterations include decreased

Answer 18

sodium

Question 19

Cushing’s: Dietary alterations include increased intake of p____ p____ and c_____

Answer 19

potassium, protein, and calcium.

Question 20

Cushing’s: Assess for indications of _____volemia

Answer 20

hypervolemia

Question 21

Cushing’s syndrome tx: tapering off _____ or managing the symptoms may be necessary.

Answer 21

glucocorticoids

Question 22

Cushing’s: Aminoglutethimide decreases adrenal hormone synthesis to provide __ ___ symptom relief

Answer 22

short-term

Question 23

Cushing’s tx: Aminoglutethimide, a corticosteroid inhibitor: monitor for

Answer 23

hypotension

Question 24

Cushing’s: an antifungal agent that when taken in high dosages inhibits adrenal corticosteroid synthesis.

Answer 24

Ketoconazole

Question 25

Cushing’s: Used when bilateral adrenal hyperplasia is the underlying cause of the condition

Answer 25

Spironolactone

Question 26

Radiation therapy for Cushing's caused by tumor: Avoid applying ___, other than those prescribed by the radiologist to affected areas.

Answer 26

lotions

Question 27

Radiation therapy for Cushing's caused by tumor: Expect fatigue and ___ ___ due to radiation.

Answer 27

altered taste

Question 28

Cushing’s: depending on the cause you may need a Hypophysectomy, which is removal of

Answer 28

pituitary gland

Question 29

Hypophysectomy: you may need to Administer _____ to prevent an abrupt drop in ___ level

Answer 29

glucocorticoids | cortisol

Question 30

hypophysectomy: Advise the client to avoid

Answer 30

coughing, blowing his nose, or sneezing

Question 31

hypophysectomy: Numbness at the surgical site and a diminished sense of smell may be experienced for

Answer 31

3 to 4 months after surgery.

Question 32

hypophysectomy: If bending is required to pick up an object or to tie shoes,

Answer 32

bend at the knees.

Question 33

hypophysectomy: oral care

Answer 33

avoid brushing teeth for 2 weeks. Advise the client to floss and rinse his mouth.

Question 34

hypophysectomy: To avoid constipation, which contributes to increased intracranial pressure, the client should eat high-fiber food. ___ ___ (Colace) also can be used to prevent constipation.

Answer 34

Docusate sodium

Question 35

Adrenalectomy: Provide _____ and hormone replacement as needed.

Answer 35

glucocorticoid

Question 36

Cushing’s: Complications: due to an increase in cortisol, you could have a GI issue:

Answer 36

decreased stomach mucus.

Question 37

Cushing’s: Complications: tx of decreased stomach mucus

Answer 37

antiulcer meds, and watch out for GI bleed

Question 38

Cushing’s: Complications: hypocalcemia increases risk for

Answer 38

fractures

Question 39

Cushing’s: Complications: Risk for infection due to

Answer 39

immunosuppression

Question 40

Sudden drop in corticosteroids due to sudden withdrawal of medication or tumor removal

Answer 40

adrenal crisis

Question 41

adrenal crisis

Answer 41

Sudden drop in corticosteroids due to sudden withdrawal of medication or tumor removal

Question 42

adrenal crisis: Administer

Answer 42

glucocorticoids

Question 43

During ___, additional glucocorticoids may be needed to prevent adrenal crisis.

Answer 43

times of stress