Cushing’s Syndrome
Cushing’s syndrome is an uncommon disorder caused by elevated blood levels of cortisol. The adrenal glands produce cortisol. An over production of this hormone by the adrenals or the excessive administration of cortisone creases to treat any number of diseases can cause this disorder. Most often long term use of oral corticosteroid medications are used for the treatment of rheumatoid arthritis, inflammatory bowel disease or asthma.
The excess cortisol can cause a tumor in the pituitary gland to form which increases the production of adrenocorticotropic hormone (ACTH). The excessive release of ACTH can cause hypertension, diabetes mellitus, osteoporosis, and muscle weakness.
An adrenal tumor or overgrowth of the adrenal cortex cells can also cause Cushing’s syndrome. Tumors in other parts of the body may also produce excess ACTH causing Cushing syndrome.
The best way to prevent this condition from occurring is to not take corticosteroids on a long-term basis. If you have a health problem that requires the use of corticosteroids, it is best to take the lowest possible dose.
The single most important intervention a nurse can have on a patient with Cushing syndrome is to prevent the patient from getting an infection while in the hospital. This is best accomplished by ensuring a clean and sanitized environment and tools are used. A person with Cushing syndrome will likely need surgery to remove a pituitary or adrenal tumor. Radiation therapy is likely to be required which will cause a weakened immune system vulnerable to bacteria and infection. The repeated use of the cortisol creams will likely have weakened the skin making potential infection possible.
