Use of corticosteroid medications prednisone Cushing Syndrome Excessive

Use of corticosteroid medications prednisone cushing

This preview shows page 23 - 28 out of 28 pages.

Use of corticosteroid medications (prednisone) Cushing Syndrome Excessive adrenocortical activity. Manifestations:
Image of page 23
Cushing’s Syndrome Diagnostics Cortisol levels-elevation in plasma cortisol 24 hr urine cortisol-elevation in free cortisol ACTH-hypersecretion by pituitary Dexamethasone suppression test Oral dexamethasone given in eve/bedtime plasma cortisol levels obtained around 8am next day. If your cortisol level remain high=Cushings.
Image of page 24
Taking dexamethasone should reduce ACTH level and lead to a decreased cortisol level. Nursing Process: The Care of the Patient With Cushing Syndrome—Assessment Activity level and ability to carry out self-care Skin assessment Changes in physical appearance and patient responses to these changes Mental function Emotional status Medications Nursing Process: The Care of the Patient With Cushing Syndrome—Diagnosis Risk for injury r/t weakness Risk for infection r/t altered inflammatory process Self-care deficit r/t weakness/fatigue/muscle weakness Impaired skin integrity Disturbed body image Disturbed thought processes Nursing Process: The Care of the Patient With Cushing Syndrome—Planning and Interventions Goals may include: decreased risk of injury, decreased risk of infection, increased ability to carry out self-care activities, improved skin integrity, improved body image, improved mental function, absence of complications
Image of page 25
Pheochromocytoma Benign Tumor of adrenal medulla ↑ catecholamines Men & women equally 40-50 yrs Family tendency Diagnostic Cortisol levels 24 hr urine for catecholamines VMA & MN (metanephrine-catecholamine metabolite) Serum catecholamines MRI, CT 5 H’s Hypertension Headache Hyperhidrosis Hypermetabolism Hyperglycemia Management Episodic Manage HTN, tachycardia, anxiety Bed rest
Image of page 26
Head of bed elevated-promotes orthostatic decrease in b/p Medications Goal: control HTN Antihypertensive Surgical Surgical removal of tumor adrenalectomy Laproscopic/open Quiet environment Vital Signs, EKG Fluid & electrolyte Glucose monitoring Corticosteroids pre & post -op Corticosteroid Therapy Suppress inflammation and autoimmune response, control allergic reactions, and reduce transplant rejection Patient education: refer to Table 52-5 Timing of doses Need to take as prescribed, tapering required to discontinue or reduce therapy Potential side effects and measures to reduce side effects
Image of page 27
Image of page 28

You've reached the end of your free preview.

Want to read all 28 pages?

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture