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A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

A.

Assess blood glucose level

B.

Assess for neck vein distention

C.

Weigh the client daily

D.

Monitor for postural hypotension

E.

Monitor for an irregular heart rate

Question Solution

Correct Answer : A,B,C,E

Rationale: 

 

A. Assessing blood glucose levels is important because Cushing's syndrome can cause insulin resistance, leading to hyperglycemia. 

 

B. Assessing for neck vein distention is necessary as it can indicate fluid overload, a common issue in Cushing's syndrome due to increased cortisol levels. 

 

C. Weighing the client daily helps monitor for weight gain, which is a characteristic of Cushing's syndrome due to fat redistribution and fluid retention. 

 

D. Monitoring for postural hypotension is less relevant in Cushing's syndrome; clients often experience hypertension rather than hypotension. 

 

E. Monitoring for an irregular heart rate is important as electrolyte imbalances (like hypokalemia) associated with Cushing's can lead to cardiac arrhythmias.


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Correct Answer is A

Explanation

Rationale:

A. Decreasing sodium intake is crucial in Cushing's disease due to the risk of fluid retention and hypertension associated with excess cortisol levels.

B. Increasing calorie intake is not typically recommended; managing weight and controlling calorie intake is often necessary.

C. Limiting potassium-rich foods is not appropriate, as patients with Cushing's disease often require adequate potassium to balance the effects of increased sodium and cortisol.

D. A balanced diet with adequate protein is important; focusing solely on carbohydrates at the expense of protein is not advisable for nutritional health.

Correct Answer is C

Explanation

Rationale:

A. Soaking feet is not recommended for clients with diabetes as it can cause skin maceration and increase the risk of infection.

B. Wearing sandals exposes the feet to injury and is not recommended for clients with diabetes. Closed-toed shoes are better for protecting the feet.

C. Daily foot inspection for sores, cuts, or bruises is essential for clients with diabetes to prevent infections and complications like diabetic ulcers.

D. Lotion should not be applied between the toes because it can promote excess moisture and fungal infections.

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