Medical-surgical Nursing Demystified

(Sean Pound) #1

(^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

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