The nurse is assessing a patient with Cushing syndrome. Which ...

[MGLQZ]

The nurse is assessing a patient with Cushing syndrome. Which findings should the nurse report for immediate follow-up?
 
  1. serum potassium 2.5 mEq/L and blood pressure 150/90
  2. serum sodium 145 mEq/L and reports of muscle weakness
  3. serum calcium 11 mg/dL and reports of feelings of depression
  4. serum phosphorus 3 mg/dL and hirsutism

Question 2

A patient with suspected Cushing syndrome is prescribed a 24-hour urine collection. What should the nurse explain to the patient about the reason for this urine collection?
 
  1. It measures the amount of cortisol in the urine over 24 hours.
  2. At least 2,000 mL of urine is required to perform the test.
  3. It identifies urine specific gravity changes over a 24-hour period.
  4. The 24-hour timeline reduces unwanted effects of medications excreted in the urine.

[b614102004]

Answer to Question 1

Correct Answer: 1
Hypokalemia and hypertension occur with Cushing syndrome as potassium is lost and sodium is retained. The other laboratory values and patient manifestations do not need to be reported for immediate follow-up.

Answer to Question 2

Correct Answer: 1
If the dexamethasone test is positive, a test for urinary free cortisol is made. This measures the amount of cortisol in the urine over 24 hours. The 24-hour urine collection is not performed because 2 L of urine is needed, to measure urine specific gravity, or to ensure medication excretion in the urine.