Question

A nurse is assessing a client who has Cushing's syndrome following long-term use of glucocorticoids for the treatment of an autoimmune disorder. Which of the following findings should the nurse expect?

1) Vitiligo
2) Osteoporosis
3) Myxedema
4) Heat intolerance

Answer 1

The nurse should expect to observe signs of osteoporosis in a client with Cushing's syndrome, due to long-term use of glucocorticoids causing hypersecretion of cortisol, which weakens the bones.

Step-by-step explanation:

The client with Cushing's syndrome who has been using glucocorticoids for an extended period of time is likely to experience a range of symptoms due to the hypersecretion of cortisol. Among these, the nurse should expect to find signs of osteoporosis, which is a common outcome of prolonged elevated cortisol levels. This occurs because cortisol promotes the breakdown of proteins to make glucose via gluconeogenesis, and in the process, can lead to the weakening of bones.

Other potential symptoms the nurse might observe in a patient with Cushing's syndrome include obesity, diabetes, hypertension, excessive body hair, and psychiatric issues such as depression. Observably, patients with Cushing's syndrome can also have a distinct physical appearance with fat accumulation in the face and neck, known as 'moon face,' and between the shoulders, sometimes referred to as a 'buffalo hump.'

Treatments for this condition are aimed at reducing the excessive levels of cortisol. Approaches can vary from discontinuing external glucocorticoids, if these are the cause, to surgery in the case of tumors, radiation therapy, or medication to regulate cortisol levels.