Case StudyCushings Essay example - 1243 Words

Case Study 78 Cushing’s Syndrome Scenario You graduated 3 months ago and are working with a home care agency. Included in your caseload is J.S., a 60-year-old man suffering from chronic obstructive pulmonary disease (COPD) related to (R/T) cigarette smoking. He has been on home oxygen, 2 L oxygen by nasal cannula (O2/NC), for several years. Approximately 10 months ago, he was started on chronic oral steroid therapy. Medications include ipratropium-albuterol (Combivent) inhaler, formoterol (Foradil) inhaler, dexamethasone (Decadron), digoxin, and furosemide (Lasix). On the way to J.S.’s home, you make a mental note to check him for signs and symptoms (S/S) of Cushing’s syndrome. Clinical Presentation †¢ Centripedal (truncal) obesity or†¦show more content†¦Prednisone can cause upset stomach. It can have serious side effect with vision problems. If it’s not helping with joint pain then the dose may need altering. 8. Differentiate between the glucocorticoid and mineralocorticoid effects of prednisone. Mineralocorticoids= †¨The name mineralocorticoid derives from early observations that these hormones were involved in the retention of sodium, a mineral. The primary endogenous mineralocorticoid is aldosterone, although a number of other endogenous hormones (including progesterone and deoxycorticosterone) have mineralocorticoid function. †¨Ã¢â‚¬ ¨Aldosterone acts on the kidneys to provide active reabsorption of sodium and an associated passive reabsorption of water, as well as the active secretion of potassium in the principal cells of the cortical collecting tubule and active secretion of protons via proton ATPases in the lumenal membrane of the intercalated cells of the collecting tubule. This in turn results in an increase of blood pressure and blood volume. †¨Ã¢â‚¬ ¨Ã¢â‚¬ ¨ Glucocortiocoids= †¨Glucocorticoids (GC) are a class of steroid hormones that bind to the glucocorticoid receptor, which is present in almost every vertebrate animal cell. †¨Ã¢â‚¬ ¨GCs are part of the feedback mechanism in the immune system that turns immune activity (inflammation) down. They are therefore used in medicine to treat diseases that are caused by an overactive immune system, such as allergies, asthma, autoimmune diseases and sepsis. GCs have