Definition of Cushing's syndrome
Cushing's syndrome is a condition caused by hyperadrenocorticism, is more often found in women, due to neoplasms in the adrenal cortex / anterior pituitary, or a result of long-term intake of glucocorticoids for therapeutic interest (Dorland).
Etiology of Cushing's syndrome
- Excessive activity of the adrenal cortex
- Corticosteroids / ACTH excess
- Adrenal cortex hyperplasia.
Symptoms of Cushing's syndrome
Most people with Cushing syndrome will have:
- Upper body obesity (above the waist) and thin arms and legs
- Round, red, full face (moon face)
- Slow growth rate in children
Skin changes that are often seen:
- Acne or skin infections
- Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
- Thin skin with easy bruising
Muscle and bone changes include:
- Backache, which occurs with routine activities
- Bone pain or tenderness
- Collection of fat between the shoulders (buffalo hump)
- Rib and spine fractures (caused by thinning of the bones)
- Weak muscles
Women with Cushing syndrome often have:
- Excess hair growth on the face, neck, chest, abdomen, and thighs
- Menstrual cycle that becomes irregular or stops
- Decreased or no desire for sex
- Impotence
- Mental changes, such as depression, anxiety, or changes in behavior
- Fatigue
- Headache
- Increased thirst and urination
Management of Cushing's Syndrome
As more Cushing's Syndrome is caused by a pituitary tumor than adrenal tumor, the treatment is often directed at the pituitary gland.
- Transsphenoidal hypophysectomy, surgical removal of the tumor.
- Radiation pituitary gland, takes several months to control the symptoms.
- Adrenalectomy, the treatment of choice for patients with primary adrenal hypertrophy.
- Baffle adrenal enzyme preparations (ie, metyrapon, aminoglutethimide, mitotane, ketoconazole) to reduce hiperadrenalisme if due to ectopic ACTH secretion.
Nursing Care Plan for Cushing's Syndrome
Nursing Diagnosis for Cushing's Syndrome
- Risk for injury and Risk for infection related to weakness and changes in protein metabolism and inflammatory response.
- Self-care Deficit: weakness, feeling of tiredness, muscle atrophy and changes in sleep patterns.
- Impaired skin integrity related to edema, impaired healing and the skin is thin and fragile.
- Disturbed Body Image related to changes in physical appearance, sexual dysfunction and decreased activity levels.
- Disturbed Thought Processes related to fluctuations in emotions, irritability and depression.
This sounds so difficult to care for let alone live with. I feel so sorry for anyone who has this :(
ReplyDeleteMai | HHA Quest Blog