Physiological Adaptation Q 148

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Nurse Sugar is assessing a client with Cushing’s syndrome. Which observation should the nurse report to the physician immediately?

  

     A. Pitting edema of the legs

     B. An irregular apical pulse

     C. Dry mucous membranes

     D. Frequent urination

    

    

Correct Answer: B. An irregular apical pulse

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Because Cushing’s syndrome causes aldosterone overproduction, which increases urinary potassium loss, the disorder may lead to hypokalemia. Therefore, the nurse should immediately report signs and symptoms of hypokalemia, such as an irregular apical pulse, to the physician.

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Option A: Edema is an expected finding because aldosterone overproduction causes sodium and fluid retention.

Option C: Dry mucous membranes is not a symptom of Cushing’s syndrome. Thinning of the skin and mucous membranes occur because cortisol causes the breakdown of some dermal proteins along with the weakening of small blood vessels.

Option D: Frequent urination signals dehydration, which isn’t associated with Cushing’s syndrome. Short term administration of adrenocorticotropic hormone or glucocorticoids causes an increased glomerular filtration rate. Glomerular dysfunction leads to proteinuria and albuminuria.

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