Free Cushing Syndrome and Addison's Disease Essay Sample

The endocrine system is significant in controlling growth and development, in addition to regulating various body functions. For example, functions such as metabolism and reproduction are under the tight control of the endocrine system. Any dysfunction in the endocrine system leads to diseases that can adversely affect the body’s physiological function. For instance, adrenal problems can lead to either Cushing’s syndrome or Addison’s diseases. Cushing’s syndrome occurs due to hypercortisolism, while Addison’s disease occurs due to adrenal insufficiency. Therefore, while these diseases result from adrenal problems, they differ in pathophysiology, clinical manifestations, treatment, and the intervention.

 
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Pathophysiology

Cushing’s syndrome occurs due to hypercortisolism. Two factors increase the risk of this problem. The first one is the intake of corticosteroid drugs in high doses or for a long time. An example of such medications is prednisone, which mimics the synthetic cortisol produced in the body. Some patients may have inflammatory conditions, such as asthma and lupus. These problems are chronic and may require medications, which can be prescribed for extended periods. The treatment process exposes the body to the increased cortisol levels, leading to Cushing’s syndrome. Another factor is hyperadrenalism, which may sometimes be idiopathic or caused by adrenocorticotropic hormone (ACTH). According to Hinkle and Cheever, ACTH is significant in regulating cortisol production. When it is produced in excess, it increases cortisol production, leading to Cushing’s syndrome. Some of the factors that may cause hyperadrenalism are pituitary adenoma, genetics, or the presence of an ACTH-secreting tumor. These risk factors must always be assessed in all patients with Cushing’s syndrome.
Conversely, Addison’s disease occurs due to adrenal insufficiency, and it is uncommon. One of the factors that lead to this problem is the damage to the adrenal glands. This problem impairs normal cortisol and adrenal production. Adrenal insufficiency can also be idiopathic. For example, Hinkle and Cheever indicate that autoimmune diseases can damage the adrenal cortex, which is viewed as a foreign body, leading to primary adrenal insufficiency. Thus, in most cases, people who develop Addison’s disease usually have another autoimmune condition. In some cases, benign tumors, pituitary surgery, and inflammatory problems can reduce pituitary hormone production, leading to low ACTH. This problem can eventually lead to secondary adrenal insufficiency.

Clinical Manifestations

Patients with Cushing’s syndrome have various symptoms depending on the cortisol level. For example, the patient may experience weight gain. Fatty tissue deposition around the upper parts of their backs is also common and may be seen in their faces, known as moon faces, and shoulder, known as buffalo hump. Other symptoms include pink or purple stretch marks on their skins, abdomen, and arms. The skin may also be prone to bruises, which take time to heal. Acne is also another predominant syndrome that may be experienced with the condition. There may be cases of irregular or absent menstrual periods experienced over a particular time frame in women.
However, in Addison’s disease, symptoms may manifest over time. This issue makes it difficult for both patients and healthcare providers to track the condition and diagnose it early. A patient with this condition can experience extreme fatigue, coupled with weight loss and loss of appetite. They further experience hyperpigmentation, the darkening of the skin at the onset of the condition. Hypotension can also be witnessed, and the patient may periodically faint. There may also be hypoglycemia, low blood sugar. In other cases, gastrointestinal symptoms may be evident, including nausea, diarrhea, and vomiting. Women may experience body hair loss and general dysfunction in their sexual experiences. All these symptoms can lead to discomfort, necessitating seeking care.

Treatment

The main goal of treating Cushing’s syndrome is to restore the adrenal gland’s physiological functioning or lower the cortisol level. For patients whose Cushing’s syndrome occurs due to medication intake, the treatment plan involves lowering the dosage. This process reduces the cortisol level and relieves the symptoms, preventing any possibility of complications. However, if the medications are eliminated abruptly, patients may experience deficient cortisol levels. For this reason, the drugs have to be tapered off to ensure that the body achieves normal cortisol production. The first-line treatment for patients with a tumor of the adrenal gland is surgical resection. This intervention reduces cortisol production and relieves the symptoms. In some cases, patients may not be in a condition to undergo surgery. In such cases, radiation therapy is always done to restore normal cortisol production. Finally, drugs that reduce the cortisol level, such as Lysodren, are prescribed if the above medications fail. Overall, the mode of treatment depends on the patient’s condition and the readiness to undergo treatment.
However, the primary goal of managing Addison’s disease is to correct the steroid hormone level. The first line of treatment in the management of the condition is the administration of hydrocortisone. The treatment perspective’s expected dose is between 50 mg/m2 to 100 mg/m2. The treatment can be given as a continuous infusion. This therapy is significant in restoring the hormone level and alleviating the symptoms. The administration of steroid therapy is the primary intervention for patients with this condition unless if the patient goes into the Addisonian crisis.

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Nursing Interventions

While pharmacological treatment is essential, nursing care is crucial in facilitating coping with the condition. For example, in Cushing’s syndrome, nurses must implement three roles to ensure that they recover from the condition. The first one is to administer the prescribed medications. This intervention is useful in restoring cortisol levels. The second one is to monitor the condition of the patient. This intervention is useful in assessing the physiological status of the patient and recommending useful therapies. The last one is to teach patients to care for themselves. Patients should be educated on eating foods high in calcium to strengthen bones. Patients must also be educated on getting back to activities slowly and monitoring their mental health that can deteriorate due to the disease. All these interventions can enhance self-management for patients with Cushing’s syndrome.
Similarly, in Addison’s disease, nurses should implement the three interventions. First, they have to administer any prescribed therapies. Secondly, they must learn how to monitor the patient’s status. For example, they must regularly assess the levels of consciousness as well as skin warmth. Vital signs must also be monitored. There should be a periodic review of the blood pressure and other signs that indicate deterioration in the patient’s health status. Finally, nurses must teach patients on self-care. For example, patients should be educated to minimize stressful environments. The intervention is significant in facilitating coping with the symptoms in the process of recovery.

Conclusion

Cushing’s syndrome or Addison’s disease can lead to severe symptoms, but they can be managed. Cushing’s syndrome occurs due to cortisol’s excess production, while Addison’s disease occurs due to damage in the adrenal glands. Patients with Cushing’s syndrome present with symptoms such as weight gain and fat tissue deposition, while those with Addison’s disease exhibit weight loss and general fatigue. The goals of managing Addison’s disease is to increase the cortisol level, while that of managing Cushing’s syndrome is to lower the cortisol level. Nurses must implement three interventions that include administering medications, assessing patients, and educating them on self-management. The integration of nursing and medical care can facilitate recovery and ensure that the patient copes with the disease.

 

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