1. 200 300 400 500 100 200 300 400 500 100 200 300 400 500 100 200 300 400 500 100 200 300 400 500 100 KEY TERMS DX TESTS RISK FACTORS CANCER PATHOPHYS HODGE- PODGE

2. Abnormalities caused by excess corticosteroids

3. Cushing’s syndrome

4. Glucocorticoids, mineralcorticoids, androgens

5. Corticosteroids

6. Adrenocortical insufficiency

7. Addison’s disease

8. Most common cause of Addison’s disease

9. Autoimmune response

10. Disease of excess secretion of catecholamines causing severe hypertension

11. Pheochromocytoma

12. Moon face, buffalo hump, wt. gain, muscle wasting of arms and legs, hypokalemia, hyperglycemia, proteinuria, calcium in the urine, renal calculi, osteoporosis, susceptibility to infections

13. Symptoms of Cushing’s syndrome

14. Electrolyte and fluid imbalance, dehydration, water loss, hypovolemia

15. Results of Addison’s disease

16. Nursing interventions for major abd surgery, Administer large amounts of hydrocortisone, monitor for fluctuations in BP, avoid stress, allow rest, give sedatives, careful I and O, administer IV solutions, Vasopressors may be given, avoid stimulants such as coffee, tea, sodas

17. Nursing Interventions for pheochromocytoma surgery

18. Loss of ability to concentrate, irritability, anxiety, euphoria, insomnia, irrationality, psychosis, suicidal, depression, loss of libido, bachache, increased appetite

19. Subjective nursing assessment of cushing’s syndrome

20. Weakness, fatigue, craving for salt, postural hypotension, vertigo, syncope, headache, disorientation, abd or low back pain, anxiety, apprehension, tolerating stress poorly

21. Subjective assessment for Addison’s disease

22. Ecchymosis, petechiae, thin skin, delayed wound healing, abd wt gain with striae, edema, hypertension, hyperglycemia, hirsutism, menstrual irregularities, deepening voice, undetected infection

23. Objective nursing assessment data for Cushing’s syndrome

24. Abnormally low or high body temp, orthostatic hypotension, hyponatremia, hyperkalemia, nausea, vomiting, sudden severe drop in BP, cyanosis

25. Adrenal crisis

26. Monitor circulatory status, I and O, daily wt. check skin turgor, frequent fluids, monitor temp and BP, monitor response to steroid drugs, keep environment free from stress, screen and exclude visitors with infectious disease. Teach patient to carry and inject 100mg IM hydrocortisone and may have to take extra medications during times of stress

27. Nursing interventions for Addison’s

28. Elevated plasma cortisol, Plasma ACTH elevated or decreased, skull radiograph, adrenal angiography, 24 hr urine showing increased17- ketosteroids and 17-hydroxysteroids, hyperglycemia, glycosuria, Abd US and CT

29. Diagnostic factors in Cushing’s syndrome

30. Adrenal toxic agent

31. Mitotane

32. Stress producing situations, infections, surgery, trauma hemorrhage, psychological stress etc.

33. Precipitation factors for adrenal crisis

34. Pt may expect to have major life style changes, possibly many complications and shortened life expectancy depending on whether cause is benign or malignant

35. Prognosis for Cushing’s disease

36. Low in sodium to reduce edema, reduced calories and carbohydrates to help control hyperglycemia, high in potassium to help correct hypokalemia

37. Diet for Cushing’s disease

38. Gentle handling to prevent skin impairment, frequent turning and ambulation if possible, elbow and heel protectors, eggcrate mattress to prevent decubs, ADLs with rest periods, encourage verbilazition of concerns, monitor for depression and suicidal ideations

39. Nursing interventions for Cushing’s disease

40. 24 hr 17-hydroxysteroids, 17- ketosteroids

41. Diagnostic tests for Cushing’s and Addison’s diseases

42. Hyponatremia, hyperkalemia, hypoglycemia, 24 hr urine showing decreased 17-ketosteroids and 17- hydroxysteroids, ACTH stimulation test showing low plasma cortisol and aldosterone levels

43. Diagnostics for Addison’s disease

44. Plasma cortisol levels increased,

45. Cushing’s syndrome

46. Hydrocortisone and fludrocortisone, fluid and electrolyte replacement

47. Tx for Addison’s disease

48. A life threatening Addisonian crisis

49. Adrenal Crisis

50. Sudden severe drop in blood pressure, nausea, vomiting, extremely high temperature, cyanosis

51. Adrenal Crisis