CONDE, ANTONETTE Q.

​BSN4 BLK6​​
Jan 9, 2023
NCM118 N036

Assessment and Management of Patients with Endocrine Disorders (Pt 2)

Pre-lecture Quiz

True or False: Write T if the statement is True and F if the statement is False
1. The major function of the adrenocortical hormone is the regulation of serum glucose and
sodium. TRUE
2. Cushing syndrome is a group of symptoms produced by an over secretion of
adrenocorticotropic hormone; characterized by truncal obesity, “moon face,” abdominal striae,
and hypertension. TRUE
3. Hypertension, hypermetabolism, and hyperglycemia are clinical manifestations of Diabetes
Insipidus. FALSE
4. Acromegaly is characterized by progressive enlargement of peripheral body parts resulting
from excessive
secretion of growth hormone.TRUE
5. Hypophysectomy is the removal or destruction of all or part of the pituitary gland. TRUE
Fill-in-the-Blank. Read each statement carefully then write the best response on the space
provided.
1. The major action of the HYPOTHALAMUS is controlling the release of pituitary hormones.
2. Over secretion of the anterior pituitary gland most commonly involves ACTH or growth
hormone and results in CUSHING’S syndrome or acromegaly.
3. OXYTOCIN and antidiuretic hormone secreted by the posterior pituitary
4. DIABETES INSIPIDUS is a condition in which abnormally large volumes of dilute urine are
excreted as a result of deficient production of vasopressin
5. ADDISON’S disease occurs when the adrenal cortex function is inadequate to meet the
patient’s need for cortical hormones

Assessment and Management of Patients with Endocrine Disorders

Case Study: Cushing Syndrome
Patient Profile: Tom is a 29-year-old high school teacher. He seeks the advice of his health care
provider because of changes in his appearance over the past year.
Subjective Data
• Reports weight gain (particularly through his midsection), easy bruising, and edema of his feet,
lower legs, and hands
• Has been having increasing weakness and insomnia
Objective Data
• Physical examination: BP 150/110; 2+ edema of lower extremities; purplish striae on abdomen;
thin extremities with thin, friable skin; severe acne of the face and neck
• Blood analysis: Glucose 167 mg/dL; white blood cell (WBC) count 13,600/mm3; lymphocytes
12%; red blood cell (RBC) count 6.6 million/mm3; K+ 3.2 mEq/L
Critical Thinking & Discussion Questions
1. Discuss the probable causes of the alterations in Tom’s laboratory results.
The patient is affected by the disease of crushing syndrome. That’s why the all changes came in
his body. Too much of the hormone cortisol in the body causes Cushing Syndrome. Cortisol,
which is produced in the adrenal glands, plays a variety of roles in the body.

2. Explain the pathophysiology of Cushing syndrome.

When stimulated by ACTH, the adrenal gland secretes cortisol and other steroid hormones.
ACTH is produced by the pituitary gland and is released into the petrosal venous sinuses in
response to stimulation by a corticotropin-releasing hormone from the hypothalamus.

3. What diagnostic testing would identify the cause of Tom’s Cushing syndrome?
Urine Blood Tests, Saliva Tests, Imaging tests, and Petrosal Sinus Sampling.

4. What is the usual treatment of Cushing syndrome?

The overall goal of Cushing’s syndrome treatment is to lower the levels of cortisol in the body.
This can be accomplished in several ways. The treatment that one receives will depend on
what’s causing the condition.

5. What is meant by a “medical adrenalectomy”?

Agents that inhibit steroidogenesis, such as mitotane, ketoconazole, metyrapone, and
etomidate, have been used to cause medical adrenalectomy. These medications are often are
toxic at the doses required to reduce cortisol secretion.

6. Priority Decision: What are the priority nursing responsibilities in the care of this patient?
The most frequent nursing diagnoses were acute pain, respiratory insufficiency, and impaired
gas exchange.
The major nursing goals for the patient include; decrease risk of injury, decrease risk of
infection, increase ability to carry out self-care activities, improve skin integrity, improve body
image, improve mental function.