question from saunders book

[shush001]

ok so i was reviewing about the addisons and cushings from saunders book, took some notes about the signs and symptoms.

Cushings:

hypokalemia, hypocalcemia, etc etc...

After that, i did a 10-item quiz and encountered a question from the cd about s/s of cushings syndrome.

W/c of the ff lab findings would the nurse expect to note in this client with cushings syndrome:

a. glucose 110

b. potassium 5.5

c. wbc 6000

d. platelet 200,000.

So everything looked normal to me except for option B. But i was like "no, it cant be! in the book it says, patients with cushings syndrome has hypokalemia!" But as i went throught the rationale, it says that:

The client with Cushing's syndrome experiences HYPERKALEMIA, hyperglycemia, an elevated WBC count, and an elevated plasma cortisol and ACTH levels. These abnormalities are due the effects of excess glucocorticoids and mineralocorticoids in the body.

SO which one is right?? the saunders book that says clients with cushing has hypokalemia or the saunders cd that says they have hyperkalemia??

[ghillbert, MSN, NP]

Hypokalemia: excess cortisol interacts with mineralocorticoid receptors in the kidneys, leading to sodium retention and potassium loss.

[perfectly_4given]

I took a look at two different books, my Kaplan and MEdspub conprehensive reviews

Kaplan says: increase sodium, increase blood volume, increase bp, DECREASE in Potassium, Increase in blood sugar,

MedsPub says the same thing

saunders def. screwed up on that one lol

[perfectly_4given]

and it make sense... because a person with cushings is going to retain water therefore retaining sodium, so since they are doing that ... it dilutes the Potassium...

[ghillbert, MSN, NP]

Hypokalemia is primarily due to the Na/K pump exchange. Na retention -> K loss.. but the dilutional effect would not help.