A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Assess for neck vein distention

Monitor for postural hypotension

Assess blood glucose level

Monitor for an irregular heart rate

Weigh the client daily

Answer and Explanation

Correct Answer : A,C,D,E

A. Assess for neck vein distention: Neck vein distention can occur in Cushing's syndrome due to fluid retention and hypertension. It is an important sign to monitor as it can indicate complications like heart failure.

B. Monitor for postural hypotension: Clients with Cushing's syndrome typically have hypertension rather than hypotension. Therefore, postural hypotension is not a common issue to monitor for in these patients.

C. Assess blood glucose level: Hyperglycemia is common in Cushing's syndrome due to increased cortisol levels, which promote glucose production and reduce glucose uptake by cells. Monitoring blood glucose is essential to manage this condition.

D. Monitor for an irregular heart rate: Cushing's syndrome can cause electrolyte imbalances (like hypokalemia), which may lead to cardiac arrhythmias, so monitoring for an irregular heart rate is important.

E. Weigh the client daily: Daily weight monitoring helps track fluid retention, which is common in Cushing's syndrome due to cortisol-induced fluid retention. This can help in managing the client’s fluid status and detecting worsening of symptoms.

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Correct Answer is C

Explanation

A. Pitting edema: Pitting edema is more indicative of fluid retention, often associated with heart failure itself, rather than a direct sign of hypokalemia.

B. Dyspnea: Dyspnea is typically a symptom of fluid overload or respiratory conditions and is not a specific indicator of hypokalemia.

C. Fatigue: Fatigue is a common symptom of hypokalemia because low potassium levels affect muscle function and overall energy levels. It is a key indicator of electrolyte imbalance.

D. Oliguria: Oliguria, or decreased urine output, is more associated with kidney function issues or severe dehydration, not directly with hypokalemia.

A. Sweat chloride test B. A stool fat content analysis C. A sputum culture D. Pulmonary function tests

Correct Answer is A

Explanation

A. Sweat chloride test: The sweat chloride test is the gold standard for diagnosing cystic fibrosis. A high level of chloride in the sweat confirms the diagnosis, as individuals with cystic fibrosis have defective chloride channels that result in excessive chloride and sodium in their sweat.

B. A stool fat content analysis: While stool fat content analysis can indicate malabsorption issues, which are common in cystic fibrosis, it does not definitively diagnose the condition. It is more useful for evaluating pancreatic function.

C. A sputum culture: A sputum culture can identify specific respiratory infections common in cystic fibrosis patients, such as Pseudomonas aeruginosa, but it does not diagnose the underlying condition.

D. Pulmonary function tests: Pulmonary function tests can assess lung function and help monitor the progression of cystic fibrosis, but they do not confirm the diagnosis.

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