Cushing syndrome,aetiology,complications,clinical manifestation,nursing managements

1. VIVEKANANDA COLLEGE OF
NURSING
by -SAKSHI PANDEY
-Bsc NURSING
2nd year
To-VINOJPRIYA
MAM

2. CUSHING SYNDROME
 Objectives-
 Define Cushing Syndrome
 Outline the aetiology of Cushing
Syndrome
 State the clinical manifestation of
Cushing syndrome
 Discuss the medical/surgical and nursing
management of a child with Cushing
syndrome
 State the complication of Cushing
syndrome

3. INTRODUCTION
 Cushing syndrome is a hormonal
disorder caused by prolonged exposer
of the body tissue to high of the
hormone cortisol
 Your adrenaline gland which are right
above your kidney, release cortisol
where they receive a chemical
message from your pituitary gland
 “The message comes in the form of
adrenocorticotropic hormones {ACTH}
,which

4. DEFINITION..
 It is a condition in which the Plasma
Cortisol level is elevated, causing
sign/symptoms of “hypercortisol” .

5. CAUSES..
 A benign tumor of the adrenal gland.
 A legion tumor in pituitary gland
 Primary hyperplasia of both adrenal
gland extensive use of cortisone
molecular {corticosteroids medication
e.g. Prednisone

6. PATHOPHYSIOLOGY
 Due to etiological factor
 Normal feedback mechanism that control
adrenocortical function are ineffective
 Resulting excess secreation of adrenal
cortical harmone
 Inadequate amount of adrena cortical
harmone is secretion
 hypercorticolism

7. CLINICAL MANIFESTATION
 Decrease libido
 Increase susceptibility to infection
,sometimes life- threadning
 Deepening of voice
 Clitoral enlargement
 Tendency of male physique in females

8. Conti…

9. DIAGNOSTIC EVALUATION
 History collection
 Physical examination
 CT scan & USG
 Radio- immune assay of plasma ACTH
 X-ray blood sample
 CRH stimulation test {to detect mild
corticosteroids excess}
 24 hrs. urinary free cortisol level{ if person
level higher than 50-100mg a day for an adult
suggest
 Cushing syndrome
 Overnight 1mg dexamethasone suppression
test

10. MANAGEMENT
 A goal is to treating cushing syndrome is
to remove, block or minimize the exposer
to excess
 Nitotane – an agent toxic to the adreno
cortex
 Metropine – to control steroid hyper
corticolism
 Amino glutethemide
 Protein anabolic steroid may be given to
facilitate –is required i.e. {protein&
potassium replacement}
MEDICAL MANAGEMENTS

11. SURGICAL MANAGEMENT
 Trans spheroidal adenomectony or
hypophysectomy - removal of pituitary
gland
 Trans frontal carinotomy –it is
necessary when pituitary tumor is
enlarge
 Bilateral adrenolectomy - hyperplasia
of adrenals

12. NURSING MANAGEMENTS
 Encourage patients to rest when
fatigued
 Encourage patient to later proper
hygiene
 Encourage patient take high rich
potassium foods like- banana ,orange
and vit-d supplement

13. COMPLICATIONS
 Osteoporosis- due to increased
glomerular rate and excretion of
calcium and decreased absorption of
calcium from intestinal tract
 Retarded linear growth –due to
increased level of cortisol interfering
with growth hormones
 Vilirisation - due to excess production
of androgen

14. NURSING DIAGNOSIS
 Fluid volume excess; related to
sodium retention causing edema and
hypertension
 Risk for injury; related to generalized
fatigue and weakness
 Risk for infection; related to impaired
immune response and oedema
 Body change disturbance; related to
physical change secondary to cushing
syndrome

15. THANKING YOU