Nursing Care of the Patient with Cushings Syndrome Nursing Diagnosis Goals/Outcome Criteria

Dadulo-Richards Nursing Interventions

Risk for Infection related to high serum cortisol levels Disturbed Thought Processes related to fluid and electrolyte imbalances

Absence of infection: normal body temperature and white blood cell count Normal thought processes: stable mood, patient denial of depression

y y

Risk for Impaired Skin Integrity related to changes in skin and connective tissues and edema Risk for Injury related to osteoporosis

Absence of injury to skin intact with minimal or no bruising Absence of fractures: no skeletal trauma or fractures

y y y

y y

Disturbed Body Image related to changes in physical appearance and function Ineffective Therapeutic Regimen Management related to lack of understanding of disease, drug therapy, diet, and self-care

Adaptation to altered body image: patient attends to appearance, grooming, makes positive comments about self Patient follows prescribed treatment: verbalizes and demonstrates self care; condition stabilizes

y y y y y y y y y

Avoid exposure to people with infections b/c of the patients decreased resistance to infection Any symptoms indicative of a cold of other problem should be reported to the physician Discuss personality changes with patient and family b/c they often accompany adrenal disorders Carefully monitor patient if the emotions change, particularly depression, become severe Inspect the skin daily to detect early signs of pressure or injuries Assist patient with limited mobility to change positions at least every 2 hours; be careful to prevent trauma to the skin Keep bed linens clean and dry Advise patients to wear shoes when out of bed to reduce the risk of foot injuries Keep the bed in low position and the call bell within reach If the patient is very weak or confused, raise the side rails Instruct patient to call for assistance when getting in and out of bed Provide an opportunity for the patient to share thoughts and concerns about body image issues Suggest clothing to conceal themselves if they are in distress Encourage and assist patients to be well groomed Reassure patient that physical changes usually improve gradually after medical or surgical treatment Provide written information to supplement verbal teaching about drugs, including drug names and dosages, schedules, and adverse effects

Nursing Care of the Patient with Cushings Syndrome

Dadulo-Richards