NRSG353 Assessment Task 1 – Case Study

Running Head: NRSG353 ASSESSMENT TASK 1 –CASE STUDY
NRSG353 ASSESSMENT TASK 1 –CASE STUDY
Name of the student:
Name of the university:
Author note:

1NRSG353 ASSESSMENT TASK 1 –CASE STUDY
Question 1-
Ms Maureen was diagnosed with rheumatoid arthritis and experienced an
exacerbation of same two months prior and also suffering from type 2 diabetes. There are
some side effects observed such as, abdominal pain, weakness and fatigue (Nee & Fried,
2018). Considering the symptoms it is concluded that she is suffering from Exogenous
Cushing syndrome, which is caused by excess level of cortisol hormone when roused by
Adrenocorticotropic hormone. Adrenocorticotropic hormone is secreted from anterior
pituitary gland as a reaction to CRH hormone from the hypothalamus (Isidori, 2015).
Cortisol is produced by the adrenal glands and helps in regulating blood pressure and
cardiovascular system, but if the level of cortisol increases it can cause Exogenous Cushing
syndrome (Isidori, 2015). It is caused by the intake of corticosteroids hormone (Ferraù &
Korbonits, 2018). Hence in the case of Ms Maureen, it is caused by the use of prednisolone
and other symptoms such as abdominal pain and fatigue are caused by the medication of
metformin due to lactic acidosis (Nee & Fried, 2018).
Cushing syndrome is common in females than in males, especially in the age between
20 to 60 years. About 2.4 million cases of exogenous Cushing Syndrome is reported every
year in Australia. The ratio between the men and women affected with Cushing Syndrome is
1 to 3 (Barber, 2017).
Cushing syndrome usually rare, but is more prevalent in case of women. One of the
risk factor involved in causing Exogenous Cushing syndrome is obesity. Type 2 diabetes and
high BP are also considered as risk factor Excessive administration of glucocorticoid drugs
can also increases the risk of the diseases, as it increases the amount of cortisol in the body.
People with obesity have increased level of cortisol into their body which causes Cushing
syndrome (Drey, et al., 2017). Patient suffering from diabetes have high blood glucose level

2NRSG353 ASSESSMENT TASK 1 –CASE STUDY
which increases the level of cortisol (Nathan, 2015). In patient with hypertension, blood
pressure increases which increases the level of cortisol (Sanchez-de-la-Torre, et al., 2015).
Hence excessive consumption of corticosteroid hormone can be considered as a risk factor of
Cushing syndrome (Pivonello, et al., 2016).
In case of patient suffering from Cushing syndrome special care from family and
friends is required with respect to diet and other requirements. Cushing syndrome also gives
rise to emotional symptoms such as anger and irritation (Katznelson, 2017). Ms Maureen will
also have to go through all these which is hampering her relation with her husband and other
family members. She feels irritated and frustrated most of the times and is not able to
concentrate neither in her studies nor in her work. Despite of the sickness she have to work,
which is making her more angry and frustrated and she ends up yelling at her family
members.
Question 2-
Signs and symptoms Underlying pathophysiology
Central obesity Obesity is one of the common symptoms
observed in patient suffering from
exogenous Ms Maureen is also suffering
from obesity. Her body fat is mainly
distributed around her between her shoulder,
face and abdominal area. Her facial
appearance is changed. Her body mass
index is 28kg/m2 which is greater than the
normal level (18.5 kg/m2), which states that
she is overweight (Gona, et al., 2017).
Cortisol is a hormone that controls the

3NRSG353 ASSESSMENT TASK 1 –CASE STUDY
process of formation of fat in the body.
Cushing syndrome is caused by the presence
of excess level of cortisol hormone. The
high level of cortisol decreases the insulin
level which in turn increases crave for
eating sugary and fatty foods. Metabolism
of fatty acid is slower and hence instead of
metabolizing the fatty acid, it is distributed
in body causing obesity (Drey, et al., 2017).
Increased glucose level Type 2 diabetes is commonly observed in
patient suffering from exogenous Cushing
syndrome. Type 2 diabetes is caused the
increase in the level of blood sugar. In case
of patient suffering from Cushing
syndrome, high amount of cortisol level is
increased in the body (Sharma, Nieman &
Feelders 2015). Cortisol manages the level
of blood sugar and hence when the level of
cortisol increases it also increases the blood
glucose level in the body of an individual
(Pivonello, et al 2016). The normal fasting
blood glucose level is 7mmol/L and the
fasting blood glucose level of Ms Maureen
is 14.0mmol/L, which states that her blood
glucose level is high and have diabetes