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.)
Assess blood glucose level
Assess for neck vein distention
Weigh the client daily
Monitor for postural hypotension
Monitor for an irregular heart rate
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 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.
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.