A nurse is caring for a client with Cushing’s syndrome. Which interventions would the nurse include in the client’s plan of care? (Select all that apply)

Monitor weight

Administer prescribed diuretics

Provide a high sodium diet

Report systolic BP greater than 139 mm Hg or diastolic BP greater than 89 mm Hg

Examine extremities for pitting edema

Answer and Explanation

Correct Answer : A,B,D,E

Reasoning:

Choice A reason: Monitoring weight is essential in Cushing’s syndrome, as excess cortisol promotes fat redistribution and weight gain. Regular weight checks help assess disease progression or treatment response, as weight gain in the trunk and face is a hallmark, and changes may indicate fluid retention or metabolic shifts.

Choice B reason: Administering prescribed diuretics is appropriate in Cushing’s syndrome when fluid retention causes edema or hypertension. Diuretics reduce excess fluid volume due to cortisol’s mineralocorticoid effects, which increase sodium and water retention, helping manage symptoms like swelling and elevated blood pressure effectively.

Choice C reason: A high sodium diet is contraindicated in Cushing’s syndrome, as cortisol’s mineralocorticoid activity causes sodium retention, leading to fluid overload and hypertension. A low-sodium diet is typically recommended to mitigate these effects and reduce the risk of edema and cardiovascular complications.

Choice D reason: Reporting blood pressure above 139/89 mm Hg is critical, as Cushing’s syndrome often causes hypertension due to cortisol’s effects on sodium retention and vascular tone. Elevated blood pressure increases cardiovascular risk, and prompt reporting ensures timely intervention to prevent complications like stroke or heart failure.

Choice E reason: Examining extremities for pitting edema is important, as cortisol’s mineralocorticoid effects cause sodium and water retention, leading to edema. Regular assessment helps detect fluid overload early, guiding diuretic therapy and fluid management to prevent complications like heart failure in clients with Cushing’s syndrome.

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Correct Answer is D

Explanation

Reasoning:

Choice A reason: A sodium level of 140 mEq/L is within the normal range and not diagnostic of Addison’s disease. This condition, caused by adrenal insufficiency, typically leads to hyponatremia due to reduced aldosterone, which decreases sodium reabsorption, making a normal sodium level uncharacteristic of the disease.

Choice B reason: A glucose level of 100 mg/dL is normal and not specific to Addison’s disease. Hypoglycemia is more common due to cortisol deficiency, which impairs gluconeogenesis. A normal glucose level does not support the diagnosis, as it does not reflect the metabolic disruptions of adrenal insufficiency.

Choice C reason: A blood pressure of 135/90 mm Hg is elevated but not diagnostic of Addison’s disease. The condition typically causes hypotension due to reduced aldosterone and cortisol, leading to low blood volume and vascular tone. Hypertension suggests another etiology, not adrenal insufficiency.

Choice D reason: A potassium level of 6.0 mEq/L indicates hyperkalemia, a diagnostic sign of Addison’s disease. Aldosterone deficiency reduces potassium excretion in the kidneys, leading to elevated serum potassium. This, combined with hyponatremia and hypotension, is a hallmark of adrenal insufficiency, making hyperkalemia a key diagnostic finding.

A. Risk for injury B. Ineffective coping C. Noncompliance D. Diarrhea

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Risk for injury is the priority for a client with left-sided hemiparesis post-stroke. Weakness on one side impairs mobility and balance, increasing fall risk. Home environment assessment ensures removal of hazards like rugs or clutter, promoting safety and preventing injuries, critical for stroke recovery.

Choice B reason: Ineffective coping may occur post-stroke due to emotional or functional challenges, but it is not the primary focus during home environment assessment. Physical safety from falls due to hemiparesis is more immediate, as coping issues are addressed through counseling, not environmental modifications.

Choice C reason: Noncompliance with treatment may affect stroke recovery but is not directly addressed by home environment assessment. Ensuring a safe environment to prevent falls due to hemiparesis takes precedence, as physical safety is critical before addressing behavioral or adherence issues in discharge planning.

Choice D reason: Diarrhea is unrelated to hemiparesis or home environment assessment post-stroke. It may occur from medications or other causes but does not pose an immediate risk like falls. The focus is on preventing injuries due to mobility issues, not gastrointestinal symptoms, in this context.

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A nurse is caring for a client with Cushing’s syndrome. Which interventions would the nurse include in the client’s plan of care? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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