Cushing syndrome

  1. Hi guys!
    Im studying for my NCLEX-RN test and i found the issue of Cushing syndrome and Addison disease very confusing.
    IS hyperkalemia occurs in Addison disease?
    Because i remember that high blood pressure and elevated sodium levels-is about Cushing syndrome.
    Welp, its confusing. Could you help me out with that please?
    Thanks a lot
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    Joined: Jun '05; Posts: 108; Likes: 3

    19 Comments

  3. by   RaggedyRN
    Quote from woman_in_love
    hi guys!
    im studying for my nclex-rn test and i found the issue of cushing syndrome and addison disease very confusing.
    is hyperkalemia occurs in addison disease? yes
    because i remember that high blood pressure and elevated sodium levels-is about cushing syndrome.
    welp, its confusing. could you help me out with that please?
    thanks a lot

    cushings patho:

    increased cortisol -> increased gluconeogenisis -> hyperglycemia

    increased aldosterone -> sodium and water retention, potassium loss

    addison's patho:

    decreased cortisol -> decreased gluconeogenesis -> hypoglycemia

    decreased aldosterone -> sodium and water loss, potassium retention

    this is from my school notes...hope it helps

    chickey
  4. by   Woman_in_love
    Quote from rn_chickey
    Cushings Patho:

    Increased cortisol -> Increased gluconeogenisis -> hyperglycemia

    Increased aldosterone -> sodium and water retention, potassium loss

    Addison's patho:

    decreased cortisol -> decreased gluconeogenesis -> hypoglycemia

    decreased aldosterone -> sodium and water loss, potassium retention

    This is from my school notes...hope it helps

    Chickey

    It sure does!
    Thank you so much, i guess the answer in my book was wrong which confused me. It said that in Cushing syndrome patient will have a hyperkalemia. Bums!
  5. by   suzanne4
    Which book were you using?
  6. by   Woman_in_love
    Quote from suzanne4
    Which book were you using?

    Its CD from the book Saunder's "Comprehensive review for the NCLEX-RN" examination" by L.A.Silvestri.
    I like this book but i guess as a human beings they do mistakes sometimes.
    There was a question like this
    What would you expect in client with Cushing syndrome.
    1)Glucose 110 mg/dl
    2) White cells-6000
    3)Platelets-200000
    4)Potassium-5.5

    I answered the glucose thing and CD answer was potassium-5.5
  7. by   suzanne4
    I would have gone with the potassium also. In Cushings, and because of the steroid use, the glucose level is going to be much higher.....usually in the 250 to 300 range during an acute episode.

    What exactly did the book say?
  8. by   thursdaygrl
    I keep Cushing's and Addison's straight this way:

    I just remember that they are both diseases caused by hypo- or hypersecretion of the Adrenal gland. If you remember that the adrenal gland secretes corticocorticoids (I always think "sugar") and mineralcorticoids (I think "salt"), you can pretty much figure out the two diseases of Cushing's and Addison's.

    Just remember: Cushing's=HYPERsecretion=hyperglycemia (increased sugar), hypernatremia (increased salt) so therefore--hypokalemia, hypocalcemia

    Addison's=HYPOsecretion=hypoglycemia (low sugar), hyponatremia (low salt), so therefore = hyperkalemia, hypercalcemia

    Once you remember these ups and downs of the two diseases, you can pretty much figure out the disease symptoms. You also have to remember that the adrenal gland also produces androgens (sex hormones) which leads to hirsutism (male and female) and male pattern baldness (females) in Cushing's.

    I take the test tomorrow morning at 9 and those are basically the only two diseases I feel good about! Now ask me a question about meds and I'm toast.
    Good luck on the test!
  9. by   Woman_in_love
    Then why hyperkalemia is the right answer?
  10. by   suzy253
    oh yeah....endocrinology...my favorite (NOT). I still get confused. I'm going to copy some of these into my notes.
  11. by   Woman_in_love
    Hi everyone!
    I wanted to know who's responsibility it's gonna be when RN delegates care to a nursing assistant or LPN and the mistake in care happens.
    I remember that there is some type of delegation when RN is responsible and some type when the LPN/CNA will be held responsible.
    Can anyone explain this to me please?
    I guess those things do show up in NCLEX-RN, so i better know them
    Thanks
  12. by   junglern
    Quote from rn_chickey
    Cushings Patho:

    Increased cortisol -> Increased gluconeogenisis -> hyperglycemia

    Increased aldosterone -> sodium and water retention, potassium loss

    Addison's patho:

    decreased cortisol -> decreased gluconeogenesis -> hypoglycemia

    decreased aldosterone -> sodium and water loss, potassium retention

    This is from my school notes...hope it helps

    Chickey
    Like a miracle by the first time, i really understand those pathos, thank you so much!

    I am taking my exam on the 29 8 am in Ny, i am driving myself crazy and with hight anxiety levels, looking in how many things that i don't feel totally ok .

    Any tips!

    Thanks again.

    Ulices.
  13. by   dinogwapo
    Quote from Woman_in_love
    Its CD from the book Saunder's "Comprehensive review for the NCLEX-RN" examination" by L.A.Silvestri.
    I like this book but i guess as a human beings they do mistakes sometimes.
    There was a question like this
    What would you expect in client with Cushing syndrome.
    1)Glucose 110 mg/dl
    2) White cells-6000
    3)Platelets-200000
    4)Potassium-5.5

    I answered the glucose thing and CD answer was potassium-5.5

    we have the same problem

    what I know in Cushing and Addison's is the 3 S (Salt, Sugar, Sex)

    in Cushing everything is increased: HyperNatremia, Hyperglycemia, Increase in Sex Hormones therefore potassium and calcium becomes low. That is why You decrease Salt in the diet and you increase your potassium.

    in Addison's everything is low so: Hyponatremia, Hyperglycemia and decrease in Sex Hormones.. so potassium and calcium becomes high.

    im pretty sure the question is wrong
  14. by   xtian0143
    can you post the books rationale on the answer.

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