(^350) Medical-Surgical Nursing Demystified
PROGNOSIS
Patients can expect a normal life span once the tumor is removed; however, tumors
may recur.
HALLMARK SIGNS AND SYMPTOMS
- Moon face during excess cortisol production
- Buffalo hump (fat pad located in the upper back) from excessive cortico-
steroids - Osteoporosis from an excess of corticosteroids, which weaken the bones
- Absence of menstruation (amenorrhea) from the effects of excess steroids
- Changes in mental status from excessive steroids
INTERPRETING TEST RESULTS
- Dexamethasone suppression test: A dose of glucocorticoid is given to test the
hypothalamus-pituitary-adrenal axis. If there is suppression with the dose, it
indicates a pituitary origin of the excess cortisol. If no suppression occurs,
the etiology is an adrenal or ectopic tumor. - Increased cortisol in 24-hour urine collection from excess production.
- Presence of a pituitary tumor or adrenal tumor on a CT; the tumor will show
on a CT scan. - Increased blood glucose due to overproduction of steroids.
- Increased sodium due to excess fluid loss.
- Decreased potassium.
TREATMENT
- Surgical removal of the pituitary tumor or adrenal tumor.
NURSING DIAGNOSES
- Disturbed body image related to illness
- Excess fluid volume related to excess water and sodium reabsorption
- Risk for infection related to immunosuppression and inadequate primary
defenses