Cushing Syndrome

Subject: Child Health Nursing

Overview

A distinctive set of symptoms known as Cushing's syndrome is brought on by high levels of free cortisol in the blood. In children, it is rare. Truncal obesity, the moon face, hypertension, back pain, osteoporosis irritability, hirsutism acne, amenorrhea in women and impotence in men, the inclination toward a male physique in women, etc. are some of the clinical manifestations of Cushing's syndrome. The cause of Cushing's syndrome affects how the condition is treated and managed. This includes hormone replacement post-surgery, bilateral adrenalectomy, thyroid extract and ADH, gonadotropins, and steroids may be required indefinitely. Advice on how to take a medication; early morning dosing to maintain the natural diurnal pattern of cortisol secretion.

Cushing syndrome:

Introduction

A distinctive set of symptoms known as Cushing's syndrome is brought on by high levels of free cortisol in the blood. In children, it is rare.

Causes

Pituitary
- The common explanation for Cushing's syndrome with adrenal hyperplasia is too much ACTH.
Adrenal
- Cushing's syndrome with excessive glucocorticoid release as a result of adrenocortical
Extrapituitary tumor.
Large-scale exogenous corticosteroid administration
Food-dependent
- Incorrect sensitivity of the adrenal glands to postprandial increases in the stomach inhibitory polypeptide's regular production.

Clinical presentation

Chronic obesity
Back and neck fat pads (buffalo hump).
Moon look.
Muscle atrophy (thin extremities, pendulous abdomen, muscle weakness).
Wounds don't heal well.
High potential for infection
Excessive bleeding from the petechiae.
Facial profusion (red cheeks).
Abdominal striae with purple tint.
Hypertension.\skyphosis.
Back pain; little stature.
Osteoporosis agitation
Hirsutism, euphoria, sadness, sleeplessness, and acne.
Voice gaining in intensity.
Citoral expansion
The propensity of females to have male physique.
Impotence in men and amenorrhea in women.

Diagnosis

The following tests can help in the diagnosis of Cushing syndrome:

Rapid sugar levels.
Electrolyte serum for hypokalemia.
Increased 17-hydroxycorticoids and 17-ketosteroids in the urine after 24 hours.
Adrenocorticotropic hormone production is often suppressed by the administration of an exogenous dose of cortisone in the cortisone suppression test.

Management

The cause of Cushing's syndrome affects how the condition is treated and managed. that comprises:

Bilateral adrenalectomy and cortical hormone replacement postoperatively.
Thyroid supplement.
Steroids, ADH, and gonadotropins can be required indefinitely.

Nursing management

Providing medication early in the day to maintain the natural diurnal pattern of cortisol secretion is part of the drug administration instructions (If a disease is caused by steroid therapy).
Before scheduling surgery, parents should receive a clear explanation of the advantages and disadvantages of the procedure.
Educate patients about drug replacement after surgery.
Surgical planning and postoperative nursing care.
Administering medication as directed.
In order to support their child, a parent should be informed of the physiological cause of the child's signs and symptoms (depression).

Things to remember

A distinctive set of symptoms known as Cushing's syndrome is brought on by high levels of free cortisol in the blood. In children, it is rare.
Truncal obesity, the moon face, hypertension, back pain, osteoporosis irritability, hirsutism acne, amenorrhea in females and impotence in males, a trend toward a male physique in females, etc. are some of the clinical manifestations of Cushing's syndrome.
The cause of Cushing's syndrome affects how the condition is treated and managed. This entails a bilateral adrenalectomy and possible permanent need for post-operative cortical hormone replacement, thyroid extract and ADH, gonadotropins, and steroids.
Advice on how to administer medication; early morning administration of medication to maintain the regular diurnal pattern of cortisol secretion.

Questions and Answers

What are the causes and sign and symptoms of cushing syndrome ?

Causes:

Pituitary: Cushing’s syndrome with adrenal hyperplasia usually attributed to an excess of ACTH.
Adrenal: Cushing’s syndrome with hypersecretion of glucocorticoids due to adrenocortical
Extrapitutary neoplasm.
Administration of large amounts of exogenous corticosteroids.
Food-dependent: Inappropriate sensitivity of adrenal glands to normal postprandial increases in secretion of the gastric inhibitory polypeptide.

Clinical Presentation:

Truncal obesity,
Fat pads on neck and back (buffalo-hump),
Moon face,
Muscular wasting (thin extremities, pendulous abdomen, muscle weakness),
Poor wound healing,
High risk of infection,
Excessive bruising / petechial hemorrhages,
Facial plethora (red cheeks),
Reddish purple abdominal striae,
Hypertension,
Kyphosis,
Backache,
Short stature,
Osteoporosis irritability,
Insomnia,
Euphoria,
Depression,
Hirsutism acne,
Deepening of the voice,
Clitoral enlargement,
The tendency toward male physique in female,
Amenorrhea in female and impotence in male.

What are the management and nursing management of cushing syndrome ?

Management:

Treatment and management depend on the cause of Cushing's syndrome. That involves:

Bilateral adrenalectomy and post-operative replacement of cortical hormone.
Thyroid extract.
ADH, gonadotropins, and steroids may be necessary for an indefinite period.

Nursing Management:

Providing medication early in the day to maintain the natural diurnal cycle of cortisol production is part of the drug administration instructions (If a disease is caused by steroid therapy).
Before scheduling surgery, parents are well informed of the pros and downsides of surgery.
Educate patients about medication replacement after surgery.
Eurgical planning and postoperative nursing care.
Administering medication as directed.
In order to support the child, the parent should be aware of the physiological cause of the signs and symptoms (depression).