6 Cushing’s Disease Nursing Care Plan

By
Paul Martin, BSN, R.N.
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Cushing’s Disease (Cushing’s Syndrome; Hypercortisolism; Adrenal Hyperfunction) is a cluster of clinical abnormalities caused by excessive levels of adrenocortical hormones (particularly cortisol) or related corticosteroids and, to a lesser extent, androgens and aldosterone. The disorder is caused by adrenocortical hyperplasia (overgrowth of adrenal cortex) secondary to pituitary overproduction of adrenocorticotropic hormone (ACTH), benign or malignant adrenal tumors that release excess glucocorticoids into the blood, prolonged or excessive administration of corticosteroids. The disease results in altered fat distribution, compromised immune system, disturbances in protein metabolism, and fluid and electrolyte imbalances.

Nursing Care Plans

Changes in the physical appearance associated with Cushing’s disease can have a notable influence on client’s body image and emotional well-being. The focus of this care plan is promoting skin integrity, improving body image, decreasing the risk of injury and improving thought processes.

Here are six (6) nursing care plans (NCP) and nursing diagnosis for Cushing’s disease or Cushing’s syndrome:

  1. Risk For Excess Fluid Volume
  2. Risk For Injury
  3. Risk For Infection
  4. Deficient Knowledge
  5. Disturbed Body Image
  6. Disturbed Thought Processes

3. Risk For Infection

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Risk For Infection

Nursing Diagnosis

  • Risk for Infection

May be related to

  • Altered protein metabolism.
  • High serum cortisol level
  • Impaired immune response

Possibly evidenced by

  • [not applicable].

Desired Outcomes

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  • Client will identify interventions to prevent risk for infection.
  • Client will display an absence of infection as evidenced by normal body temperature and normal white blood cell count.
Nursing Interventions Rationale
Assess frequently for subtle signs of infections. Corticosteroids mask signs of inflammation and infection.
Avoid unnecessary exposure to people with infections. Cortisol suppresses the immune system. Therefore clients may develop infection more frequently.
Stress the importance of adequate rest.  A client who is under long-term stress tends to suffer from bacterial infection, cold, and flu viruses.
Use strict medical and surgical asepsis when providing care. A hospitalized client is susceptible to infection from a variety of bacteria, viruses, fungi and other microorganisms that live naturally on the skin and in the hospital.
Encourage turning, coughing, and deep breathing and incentive spirometry every 2–4 hours. This will assist in the mobilization of secretions.
Stress proper handwashing techniques. Handwashing serves as the first-line defense against cross-contamination/nosocomial infections.
Emphasized the importance of good nutrition. Adequate nutrition enhances immune system natural defense mechanism
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3. Risk For Infection

See Also

You may also like the following posts and care plans:

Endocrine and Metabolic Care Plans

Nursing care plans related to the endocrine system and metabolism:

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