CHAPTER 8 Endocrine System^349
- Positive ACTH stimulation test; ACTH acts on the adrenal cortex to stimu-
late adrenal hormone secretion. An infusion of ACTH is given and the test is
positive if the infusion fails to raise the cortisol level. - Abnormal adrenal glands appear on CT scan.
TREATMENT
- Administer cortisone or hydrocortisone to replace cortisol.
- Administer fludrocortisone to regulate sodium and potassium balance.
- Maintain fluid balance.
NURSING DIAGNOSES
- Fatigue related to disease state
- Risk for deficient fluid volume
- Disturbed body image related to disease state
NURSING INTERVENTION
- Monitor fluids and electrolytes.
- Weigh the patient daily.
- Suggest bone density test for osteoporosis due to decrease in mineralo-
corticoids. - Explain to the patient:
- Medication must be taken every day.
- Wear a medical alert bracelet.
- Keep an emergency supply of medication available.
Cushing’s Syndrome
WHAT WENT WRONG?
The adrenal cortex secretes an excess of glucocorticoids or the pituitary gland an
excess of ACTH as a result of either a pituitary tumor, adrenal tumor, or from on-
going glucocorticoid therapy.
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