Cushing’s Syndrome


Etiology and Pathophysiology

■ An adrenocortical disorder exhibited by ↑secretion of cortical hormones
(androgens, mineralocorticoids, glucocorticoids) → ↓immune response,
↑Na, water retention, ↑serum glucose

■ Occurs secondary to adrenal tumor, or ↑ACTH from pituitary, steroid therapy

■ ↑Risk women 20-40yr

Signs and Symptoms

■ ↓K, ↑Na, hypervolemia, edema

■ Truncal obesity, buffalo hump, moon face, acne, hirsutism, purple
abdominal striae

■ ↓Libido

■ Muscle wasting → thin extremities

■ ↑Glucose, ↑serum cortisol, ↑17-ketosteroids, ↑17-hydroxysteroids

■ ↓ACTH (unless secondary to a pituitary problem)

■ ↑Risk of infection, osteoporosis, psychosis

Treatment

■ Adrenalectomy, removal of pituitary tumor (hypophysectomy) depending
on cause

■ If resulting from steroid therapy, D/C steroids slowly

■ Treat complications (DM, osteoporosis)

Nursing Management

■ Monitor for S&S

■ Encourage ↓Na and altered ↑K in diet

■ Protect from infection

■ Teach use of medical alert band and protection from injury (fractures
secondary to osteoporosis)

■ Provide emotional support for altered body image and labile mood

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