Mrs. A has been taking high doses of glucocorticoids for much of the past 2 years to control
severe rheumatoid arthritis. She has now developed hypertension and type 2 diabetes and
would like to stop taking the cortisone because of the unwanted changes in her appearance.
1. How does Cushing’s syndrome affect the individual?
“Cushing syndrome is caused by an excess of glucocorticoids (eg, hydrocortisone or
cortisol) (Hubert and VanMeter, 2017)”. Cushing’s syndrome can affect the body in many
ways, these changes include: “Characteristic change in the person's appearance; a moon
face (round and puffy) and a heavy trunk with fat at the back of the neck (buffalo hump)
and wasting of muscle in the limbs (Hubert and VanMeter, 2017)”.
2. Discuss how hypertension and diabetes have developed and the potential
complications of these conditions.
Cushing’s Syndrome can cause “metabolic changes include increased gluconeogenesis
and insulin resistance, which may lead to glucose intolerance; this may result in diabetes
mellitus or exacerbate an existing diabetic state (Hubert and VanMeter, 2017)”. It can
also cause “retention of sodium and water (mineralocorticoid effect), leading to
hypertension, edema, and possible hyperkalemia (Hubert and VanMeter, 2017)”.
3. Discuss other potential problems that Mrs. A may experience resulting from long-
term use of glucocorticoids.
The potential problems that can result with the use of “long-term use of glucocorticoids
can cause a loss of muscle tissue. It can also result in Cushing’s syndrome, which can
lead to a fatty hump between your shoulders, round face, weight gain, pink stretch marks,
weakened bones, diabetes, high blood pressure, thin skin, slow healing, acne, irregular,
menstrual cycles, decreased libido, fatigue, depression (Case-Lo, 2020)”.
Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her
medical history revealed that over the past 3 years, she has suffered fractures of her femur
and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial
job, drives to work, and she “does not have time for exercise.” She reports that she
consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has
not seen her physician recently nor had a recommended bone density test because of the
time and cost involved.
This study source was downloaded by 100000847795904 from CourseHero.com on 06-23-2022 06:43:27 GMT -05:00
https://www.coursehero.com/file/100600885/NR-283-Week-6-Discussiondocx/
severe rheumatoid arthritis. She has now developed hypertension and type 2 diabetes and
would like to stop taking the cortisone because of the unwanted changes in her appearance.
1. How does Cushing’s syndrome affect the individual?
“Cushing syndrome is caused by an excess of glucocorticoids (eg, hydrocortisone or
cortisol) (Hubert and VanMeter, 2017)”. Cushing’s syndrome can affect the body in many
ways, these changes include: “Characteristic change in the person's appearance; a moon
face (round and puffy) and a heavy trunk with fat at the back of the neck (buffalo hump)
and wasting of muscle in the limbs (Hubert and VanMeter, 2017)”.
2. Discuss how hypertension and diabetes have developed and the potential
complications of these conditions.
Cushing’s Syndrome can cause “metabolic changes include increased gluconeogenesis
and insulin resistance, which may lead to glucose intolerance; this may result in diabetes
mellitus or exacerbate an existing diabetic state (Hubert and VanMeter, 2017)”. It can
also cause “retention of sodium and water (mineralocorticoid effect), leading to
hypertension, edema, and possible hyperkalemia (Hubert and VanMeter, 2017)”.
3. Discuss other potential problems that Mrs. A may experience resulting from long-
term use of glucocorticoids.
The potential problems that can result with the use of “long-term use of glucocorticoids
can cause a loss of muscle tissue. It can also result in Cushing’s syndrome, which can
lead to a fatty hump between your shoulders, round face, weight gain, pink stretch marks,
weakened bones, diabetes, high blood pressure, thin skin, slow healing, acne, irregular,
menstrual cycles, decreased libido, fatigue, depression (Case-Lo, 2020)”.
Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her
medical history revealed that over the past 3 years, she has suffered fractures of her femur
and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial
job, drives to work, and she “does not have time for exercise.” She reports that she
consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has
not seen her physician recently nor had a recommended bone density test because of the
time and cost involved.
This study source was downloaded by 100000847795904 from CourseHero.com on 06-23-2022 06:43:27 GMT -05:00
https://www.coursehero.com/file/100600885/NR-283-Week-6-Discussiondocx/
