A nurse is caring for a client with Cushing's syndrome. Which assessment findings would the nurse expect? (Select all that apply.)
Purple striae
Moon face
Bronze pigmentation
Buffalo hump
Poor wound healing
Correct Answer : A,B,D,E
Rationale:
A. Purple striae (stretch marks) are common in Cushing's syndrome due to skin thinning and the redistribution of fat.
B. A "moon face" is a classic sign of Cushing's syndrome, caused by fat deposition in the face.
C. Bronze pigmentation is associated with Addison's disease, not Cushing's syndrome.
D. A "buffalo hump," or fat accumulation on the upper back, is another characteristic feature of Cushing's syndrome.
E. Poor wound healing is expected in Cushing's syndrome due to the effects of prolonged exposure to high cortisol levels, which impair immune function and tissue repair.
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Correct Answer is B
Explanation
Rationale:
A. A decreased pulse is not typically associated with pheochromocytoma. This condition is characterized by the excessive release of catecholamines, which usually leads to an increased heart rate.
B. Pheochromocytoma is a tumor of the adrenal medulla that causes excessive secretion of catecholamines, leading to episodic or sustained hypertension. Elevated blood pressure is a hallmark symptom of this condition.
C. Cold intolerance is more commonly associated with hypothyroidism and is not a typical finding in pheochromocytoma.
D. Decreased respiratory rate is not characteristic of pheochromocytoma; instead, clients may experience symptoms such as palpitations, sweating, and headaches due to the elevated catecholamine levels.
Correct Answer is B
Explanation
Rationale:
A. A low sodium diet is not appropriate for a client with SIADH and hyponatremia, as it can exacerbate the low sodium levels. Increasing sodium intake might be more appropriate depending on the clinical situation.
B. Restricting fluid intake is a standard treatment for SIADH to prevent further dilution of sodium in the blood, which is critical in managing hyponatremia.
C. Desmopressin acetate is used to treat conditions with insufficient antidiuretic hormone, such as diabetes insipidus, and is not appropriate for SIADH.
D. An IV of 0.45% sodium chloride is hypotonic and could worsen hyponatremia in SIADH. Hypertonic saline would be more appropriate if IV treatment were necessary