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 C
Explanation
Rationale:
A. Assisting the client to the bathroom might be helpful, but it is not the first action the nurse should take since the client hasn't voided for an extended period.
B. Increasing fluids may be beneficial but does not address the immediate concern of whether there is a problem with urinary retention.
C. Performing a bladder scan is the first action to determine if there is urine retention in the bladder. This information is crucial before deciding on further interventions, such as catheterization.
D. Inserting a straight catheter may be necessary if significant urinary retention is confirmed, but it should not be the first action without knowing the bladder's status.
Correct Answer is B
Explanation
Rationale:
A. Exophthalmos is typically associated with hyperthyroidism, particularly in Graves' disease, and is not a characteristic finding in hypothyroidism.
B. Weight gain is a common symptom of hypothyroidism due to the slowed metabolism caused by reduced thyroid hormone levels. Clients often report unexplained weight gain despite maintaining a normal diet and activity level.
C. Diaphoresis, or excessive sweating, is more commonly associated with hyperthyroidism, where increased metabolism leads to heat intolerance and sweating.
D. Palpitations are also more commonly associated with hyperthyroidism, where an increased heart rate and heightened sensitivity to adrenaline are common. In hypothyroidism, bradycardia or a slowed heart rate may be observed instead.