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.
- Risk For Excess Fluid Volume
- Risk For Injury
- Risk For Infection
- Deficient Knowledge
- Disturbed Body Image
- Disturbed Thought Processes
Disturbed Thought Processes
- Disturbed Thought Process
May be related to
- Chemical changes in the brain from high cortisol.
Possibly evidenced by
- Mood swings.
- Client will exhibit normal thought process and improve mentation.
|Explain to client and family the cause of emotional instability.||High cortisol levels can be experienced by the body as anxiety, and insomnia is very common in clients on steroids and with high cortisol levels.|
|Encourage client to discuss feelings and concerns.||This will assist the client in verbalizing concerns and provides the opportunity to deal with matters of the client.|
|Provide a positive and caring environment for the client.||The depressing effect of having a serious and impairing illness may also contribute to depression.|
|Repeat instructions as necessary using clear, simple language and short sentences||Cushing’s disease can affect a client’s concentration and memory.|
|Assist the client in psychotherapy.||Psychotherapy can help with depression, mood, and anxiety which are caused by Cushing’s disease.|
|Administer medications (such as ketoconazole, metyrapone) as indicated||These medications are used to lower high cortisol levels due to tumors and may be helpful relieving some of the psychiatric symptoms associated with the high cortisol state.|
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Endocrine and Metabolic Care Plans
Nursing care plans related to the endocrine system and metabolism:
- Acid-Base Balance
- - Respiratory Acidosis Nursing Care Plan
- - Respiratory Alkalosis Nursing Care Plan
- - Metabolic Acidosis Nursing Care Plan
- - Metabolic Alkalosis Nursing Care Plan
- Addison's Disease | 3 Care Plans
- Cushing’s Disease | 6 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Diabetes Mellitus Type 2 | 13+ Care Plans
- Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) | 4 Care Plans
- Eating Disorders: Anorexia & Bulimia Nervosa | 7 Care Plans
- Fluid and Electrolyte Imbalances | 10 Care Plans
- - Fluid Balance: Hypervolemia & Hypovolemia
- - Potassium (K) Imbalances: Hyperkalemia and Hypokalemia
- - Sodium (Na) Imbalances: Hypernatremia and Hyponatremia
- - Magnesium (Mg) Imbalances: Hypermagnesemia and Hypomagnesemia
- - Calcium (Ca) Imbalances: Hypercalcemia and Hypocalcemia
- Gestational Diabetes Mellitus | 4 Care Plans
- Hyperthyroidism | 7 Care Plans
- Hypothyroidism | 3 Care Plans
- Obesity | 4 Care Plans
- Thyroidectomy | 5 Care Plans