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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. Cushing syndrome is characterized by central obesity (excess adipose tissue in the trunk), slender extremities, a moon-shaped face, and other features like a buffalo hump. This is due to prolonged exposure to elevated cortisol levels.

B. High levels of potassium and low levels of sodium are not associated with Cushing syndrome, which typically presents with hypokalemia and hypernatremia.

C. Wasting of the abdomen is not a feature of Cushing syndrome. The skin may become fragile, but it is not typically calloused.

D. Edema is not a primary feature; rather, fat redistribution to the trunk and face is more common.

Correct Answer is D

Explanation

Rationale:

A. Fruity breath is a sign of ketoacidosis, a more severe complication of hyperglycemia.

B. Increased thirst (polydipsia) is a common symptom of hyperglycemia due to dehydration caused by high blood glucose levels.

C. Blurry vision may also occur with hyperglycemia, as high blood sugar can affect fluid levels in the eyes.

D. Hyperglycemia is more likely to cause an increased appetite (polyphagia), rather than a decreased one.

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