Medical Surgical Addisons vs Cushing #3

Question

The nurse is caring for a client with a diagnosis of Cushing’s syndrome with a history of anterior pituitary tumor. The nurse will assess for which of the following characteristics of Cushing’s syndrome? Select all that apply.

Answers

  1. Round face
    • Rationale:

      This answer is correct because Cushing’s syndrome has features of a round face or sometimes referred to as a “moon face”. Other features include weight gain, loss of hair, thin skin, stretch marks, feet and leg edema, fatigue, ‘buffalo hump’ between posterior shoulders, and hypertension.

  2. Hyperactive state
    • Rationale:

      This answer is not correct because fatigue, not hyperactivity is a feature of Cushing’s syndrome. Other features include a round face, weight gain, loss of hair, thin skin, stretch marks, edema of the feet and legs, ‘buffalo hump’ between posterior shoulders, and hypertension.

  3. Weight loss
    • Rationale:

      This answer is not correct because weight gain, not weight loss is a feature of Cushing’s syndrome. Other features include a round face, fatigue, loss of hair, thin skin, stretch marks, edema of the feet and legs, ‘buffalo hump’ between posterior shoulders, and hypertension.

  4. Swelling of feet and legs
    • Rationale:

      This answer is correct because Cushing’s syndrome has the feature of edema to the feet and legs. Other features include a round face, weight gain, loss of hair, thin skin, stretch marks, fatigue, ‘buffalo hump’ between posterior shoulders, and hypertension.

  5. Acne
    • Rationale:

      This answer is correct because the overproduction of androgen from the adrenal glands causes oily skin, which can lead to acne. Androgen excess is also responsible for hirsutism and thinning hair.

Overview

Cushing’s syndrome manifests itself due to a pituitary tumor that secretes ACTH, which stimulates the adrenal glands to produce too much cortisol and may produce Cushing’s. Classic characteristics of Cushing’s syndrome include round face, fatigue, weight gain, and leg edema.

Explanation

Learning Outcomes

Cushing’s syndrome is caused by too much cortisol production. This occurs due to a pituitary tumor that secretes ACTH, which stimulates the adrenal glands to produce too much cortisol and may produce Cushing’s. Cushing’s syndrome has features of weight gain, round face, loss of hair, thin skin, stretch marks, feet and leg edema, fatigue, ‘buffalo hump’ between posterior shoulders, and hypertension. The nurse should assess and report symptoms so if symptoms can be treated as soon as possible.

Test Taking Tip

Cushing’s syndrome can be remembered as being “cushy” or blown up like the Michelin man because of the increase in cortisol that causes a round face, edema of the feet and legs, and weight gain. These are also symptoms of long-term steroid use.

Video Rationale