Medsurg Final 3 Flashcards
Cushing’s disease and Cushing’s syndrome are caused by an
oversecretion of the adrenal cortex
Cushing’s disease is caused
directly by oversecretion of the adrenal cortex
Cushing’s syndrome is caused by
long-term use of glucocorticoids to treat other conditions, such as asthma or RA
affects glucose, protein, and fat metabolism; the body’s response to stress; and the body’s immune function
Glucocorticoids, like Cortisol
increases sodium absorption, causes potassium excretion in
the kidney
Mineralocorticoids, like Aldosterone
Cushing’s: Advise the client that medication therapy may be
lifelong
Cushing’s: Advise the client to eat foods high in
calcium and vitamin D
Cushing’s: The client should not use ___ or ___
alcohol or caffeine
Cushing’s: teaching: client should watch out for
GI bleeding
Cushing’s: Manifestations: Altered emotional state (may include ___ or ___)
irritability or depression
Cushing’s: Manifestations: Skin
Thin and fragile
Cushing’s: Manifestations: ___ ulcers
Gastric
Cushing’s: Manifestations: ___ edema
dependent edema
Cushing’s: Manifestations: hair
Hirsutism
____ cortisol levels are used to confirm the diagnosis of Cushing’s disease
Salivary
Dexamethasone suppression tests: _____ of cortisol excretion is indicative of Cushing’s disease
Nonsuppression
Dexamethasone suppression tests for Cushings: False positive results may occur in clients with acute illness and
alcoholism
Cushing’s: Dietary alterations include decreased
sodium
Cushing’s: Dietary alterations include increased intake of p____ p____ and c_____
potassium, protein, and calcium.
Cushing’s: Assess for indications of _____volemia
hypervolemia
Cushing’s syndrome tx: tapering off _____ or managing the symptoms may be necessary.
glucocorticoids
Cushing’s: Aminoglutethimide decreases adrenal hormone synthesis to provide __ ___ symptom relief
short-term
Cushing’s tx: Aminoglutethimide, a corticosteroid inhibitor: monitor for
hypotension
Cushing’s: an antifungal agent that when taken in high dosages inhibits adrenal corticosteroid synthesis.
Ketoconazole
Cushing’s: Used when bilateral adrenal hyperplasia is the underlying cause of the condition
Spironolactone
Radiation therapy for Cushing’s caused by tumor: Avoid applying ___, other than those prescribed by the radiologist to affected areas.
lotions
Radiation therapy for Cushing’s caused by tumor: Expect fatigue and ___ ___ due to radiation.
altered taste
Cushing’s: depending on the cause you may need a Hypophysectomy, which is removal of
pituitary gland
Hypophysectomy: you may need to Administer _____ to prevent an abrupt drop in ___ level
glucocorticoids
cortisol
hypophysectomy: Advise the client to avoid
coughing, blowing his nose, or sneezing
hypophysectomy: Numbness at the surgical site and a diminished sense of smell may be experienced for
3 to 4 months after surgery.
hypophysectomy: If bending is required to pick up an object or to tie shoes,
bend at the knees.
hypophysectomy: oral care
avoid brushing teeth for 2 weeks. Advise the client to floss and rinse his mouth.
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.
Docusate sodium
Adrenalectomy: Provide _____ and hormone replacement as needed.
glucocorticoid
Cushing’s: Complications: due to an increase in cortisol, you could have a GI issue:
decreased stomach mucus.
Cushing’s: Complications: tx of decreased stomach mucus
antiulcer meds, and watch out for GI bleed
Cushing’s: Complications: hypocalcemia increases risk for
fractures
Cushing’s: Complications: Risk for infection due to
immunosuppression
Sudden drop in corticosteroids due to sudden withdrawal of medication or tumor removal
adrenal crisis
adrenal crisis
Sudden drop in corticosteroids due to sudden withdrawal of medication or tumor removal
adrenal crisis: Administer
glucocorticoids
During ___, additional glucocorticoids may be needed to prevent adrenal crisis.
times of stress
