In Cushing's syndrome, excessive amount of glucocorticoids and mineralocorticoids will cause increase in:

IGNOU PB Bsc Entrance-2022

Medical Surgical Nursing

Easy

Appeared in: IGNOU PB Bsc Entrance-2022

Explanation

In Cushing's syndrome, there is an overproduction of corticosteroids, including mineralocorticoids like aldosterone.
Mineralocorticoids act on the kidneys to increase the reabsorption of sodium from the urine back into the bloodstream.
Water passively follows the reabsorbed sodium, leading to an overall increase in the body's fluid volume, known as fluid retention.
This fluid retention is a primary cause of the hypertension, edema, and weight gain seen in Cushing's syndrome.

Option A: Urine output decreases in Cushing's syndrome. The hormonal effects cause the kidneys to retain water, leading to reduced excretion of urine.
Option C: Potassium levels decrease (hypokalemia). The same mineralocorticoid action that causes sodium retention promotes the excretion of potassium into the urine.
Option D: Immunity is suppressed, not increased. A major effect of excess glucocorticoids is the inhibition of the immune and inflammatory responses, making the patient highly susceptible to infections.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Cushing's Syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must meticulously monitor patients with Cushing's syndrome for signs of fluid overload, including daily weights, intake/output records, and blood pressure trends. A sudden weight gain is a red flag for worsening fluid retention.
Electrolyte monitoring is crucial. The nurse should watch for signs of hypokalemia (low potassium), such as muscle weakness, fatigue, and cardiac arrhythmias, and report them promptly.
Due to immunosuppression, infection prevention is a top priority. Nurses should enforce strict hand hygiene, limit exposure to sick individuals, and monitor for subtle signs of infection, as the classic inflammatory response may be blunted.

How to Approach the Question

First, identify the core condition in the question: Cushing's syndrome.
Recall the key hormones that are in excess: glucocorticoids and mineralocorticoids.
Focus on the primary function of mineralocorticoids. Remember the mnemonic 'Salt, Sugar, Sex' for adrenal cortex hormones; mineralocorticoids primarily regulate salt (and therefore water).
Analyze the effect of mineralocorticoid excess on the body's fluid and electrolyte balance. Increased mineralocorticoids mean increased sodium and water retention.
Evaluate each option based on this understanding: Fluid retention increases, while urine output, potassium, and immunity decrease.
Select the option that correctly reflects the effect of the hormonal excess.

Concept Tested & Keywords

Concept Tested: Pathophysiology of Cushing's Syndrome
Stem keywords: Cushing's syndrome, glucocorticoids, mineralocorticoids, excessive amount
Lead-in keywords: increase in

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