Question

The client is admitted with Cushing's disease. The nurse is aware that clients with an adrenal disorder such as Cushing's disease will most likely exhibit signs of: A. Hypercalcemia B. Hyperkalemia C. Hypernatremia D. Hypermagnesemia

Short answer

Answer: Hypernatremia

Step-by-step solution

Understanding Cushing's disease

Cushing's disease is a condition caused by an excess of the hormone cortisol in the body, which is produced by the adrenal glands. This disease affects the balance of electrolytes in the body.

Evaluating the options

Let's look at each of the options given and see how they relate to Cushing's disease: A. Hypercalcemia - This refers to high levels of calcium in the blood. While Cushing's disease might cause some changes in calcium levels, it is not the primary disruption associated with the condition. B. Hyperkalemia - This refers to high levels of potassium in the blood. However, in Cushing's disease, cortisol tends to increase sodium levels while decreasing potassium levels, leading to the opposite condition called hypokalemia. C. Hypernatremia - This refers to high levels of sodium in the blood. In Cushing's disease, excess cortisol causes the body to retain more sodium, which can lead to hypernatremia. D. Hypermagnesemia - This refers to high levels of magnesium in the blood. Cushing's disease does not primarily affect magnesium levels.

Selecting the correct answer

Based on our evaluation above, the most likely sign of an adrenal disorder like Cushing's disease is: C. Hypernatremia (high levels of sodium) Thus, the correct answer is C.

Key concepts

Adrenal Disorders

Adrenal disorders involve conditions affecting the adrenal glands, which are small glands located on top of each kidney. These glands produce hormones like cortisol, aldosterone, and adrenaline that are crucial for various bodily functions. In adrenal disorders, the balance of these hormones is disrupted, affecting multiple body systems. For example:

• Cushing's Disease: This is due to abnormally high levels of cortisol, leading to symptoms such as weight gain, especially around the abdomen, high blood pressure, and muscle weakness.


• Addison's Disease: Opposite to Cushing's, this is characterized by low cortisol and aldosterone levels, leading to fatigue, low blood pressure, and weight loss.

Understanding adrenal disorders is important because they highlight how critical these hormones are for maintaining balance in the body. The effects on metabolism, blood pressure, and the immune system are significant.

• These conditions require careful monitoring and management to ensure hormone levels are balanced.


• Treatment may include medication to either inhibit or supplement hormone production.

Electrolyte Imbalance

Electrolyte imbalance occurs when the levels of electrolytes in your blood become too high or too low. Electrolytes like sodium, potassium, calcium, and magnesium are essential for:

• Maintaining fluid balance in cells.


• Enabling nerve signals and muscle contractions.
• Regulating heart function and other critical processes.

Many things can cause electrolyte imbalances, such as dehydration, medication side effects, or underlying conditions like adrenal disorders. Monitoring and correction of electrolyte levels are crucial because:

• Even minor imbalances can lead to issues like muscle cramps or fatigue.


• Severe imbalances might cause serious complications, including heart rhythm disturbances.

Hydration, diet changes, and sometimes medical interventions are used to manage and correct these imbalances, helping to restore normal function and prevent complications.

Hypernatremia

Hypernatremia is a condition where there is too much sodium in the blood. Sodium is crucial for maintaining normal nerve and muscle function, as well as fluid balance. This condition can be particularly concerning and often stems from:

• High sodium intake without adequate water consumption.


• Loss of water without sodium loss, such as through excessive sweating or diarrhea.

In the context of Cushing's disease, hypernatremia can result from the excess production of cortisol, which causes the kidneys to reabsorb sodium and expel potassium. This leads to concentrated levels of sodium in the bloodstream. Symptoms of hypernatremia often include:

• Thirst and dry mouth.


• Weakness, confusion, or irritability.
• In severe cases, it can lead to brain swelling or seizures.

To address hypernatremia, the underlying cause must be treated. Often, this includes:

• Increasing water intake to dilute sodium levels.


• Adjusting medications that may influence sodium retention, especially in adrenal disorders like Cushing's disease.