Nursing Assignment: Disease Impression, Causes, and Impact on Patient and Family

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

1NURSING ASSIGNMENT
Outline the disease, causes, incidence and risk factors. Discuss the impact of the selected
disease on the patient and their family.
On analyzing the case presentment of Ms. Maureen Smith, the disease impression can be
stated as Exogenous Cushing’s Syndrome. As mentioned by Liew et al. (2013), Exogenous
Cushing’s Syndrome is extremely common in people who take glucocorticoid medications or
other corticosteroid hormones. The syndrome typically manifests itself when the body has a
higher than normal level of the cortisol hormone. The cortisol hormone is synthesized in the
body by the adrenal gland. In this context, it should be mentioned that the term ‘exogenous’
refers to an agent outside the body. This means that Exogenous Cushing Syndrome is caused
upon taking synthetic glucocorticoid medication which might be prescribed to treat another
disorder. Glucocorticoid medications are prescribed for a number of disease conditions such as
lung diseases, joint related diseases, inflammatory bowel disease, cancer, skin diseases or brain
tumor (Lacroix et al., 2015). The medications can either be taken in the form of pills or are
administered intravenously, injected to the affected joint area, administered through enema, used
as skin creams, inhaled from inhalers or used as eye drops (Raff & Carroll, 2015).
Research studies suggest that the prevalence rate of the syndrome is 40 in every million.
The incidence rate has been studied to be 1 or 2 cases per million of the total population
(Betterhealth.vic.gov.au, 2019). Studied suggest that 60% of the syndrome is caused due to the
condition of hypercortisolism (Betterhealth.vic.gov.au, 2019). Also, the syndrome is more
common in women than in men and manifests itself in the ratio 8:1 (Raff & Carroll, 2015). Also,
Exogenous Cushing Syndrome affects women belonging to the age group between 20-40 years
(Raff & Carroll, 2015).

2NURSING ASSIGNMENT
The common risk factors for the syndrome include medical history of Type II Diabetes,
obesity, hypertension and high blood glucose level (Duan et al., 2015). It is important to note
here that, these factors are not directly responsible for causing the syndrome but have been
studied to indirectly affect the prevalence of the syndrome. In addition to this, higher cortisol due
to the intake of glucocorticoid medications, adrenal adenomas, ectopic ACTH and Pituitary
diseases are also considered as high risk factors (Duan et al., 2015).
The diagnosis of Exogenous Cushing Syndrome would negatively affect the quality of
life of the patient as well as her husband. As a result of the syndrome, the patient might feel
fatigued, emotionally unstable because of changes in her physical appearance, experience
cognitive problems, sleeping difficulties or experience depression (Starkman, 2013). The
emotional turmoil experienced by the patient would also affect her husband and deteriorate their
quality of life.
Discuss three (3) common signs and symptoms of the selected disease and explain the
underlying pathophysiology of each.
Thee three common symptoms and their underlying pathophysiology as observed in the
patient has been described in the table below:
Signs and symptoms observed in Ms. Smith Pathophysiology
Presence of round and full face as observed by her
husband
Presence of a round face or moon face is a
characteristic symptom of the Cushing syndrome.
The symptom is also referred to as a Cushingoid
appearance. The face becomes round and fluffy and
fat accumulated on the sides of the face which
makes the face looks round in the shape of a moon

3NURSING ASSIGNMENT
(Kargi & Iacobellis, 2014). The symptom is
characterized by the excessive release of the
cortisol hormone by the adrenal glands that are
located on the upper region of the kidneys (Kargi
& Iacobellis, 2014).
Presence of fat mainly around her abdominal area
and as a hump between her shoulders
Exogenous Cushing Syndrome is caused due to the
excessive secretion of the Cortisol hormone (Colao
et al., 2014). The process of accumulation and
distribution of fat is significantly influenced by a
number of genes and hormones. Studies suggest
that the adipocytes or the fat cells that are present
in the central region of the body are more receptive
to the effect of the insulin compared to the fat cells
that are present in the periphery (Tchernof &
Despres, 2013). The high level of cortisol in the
body affects the process of insulin secretion and
sensitivity and the process of fat metabolism. As a
result of which the adipocytes present in the central
region accumulate fat and appear as a buffalo hump
(Kargi & Iacobellis, 2014).
Clinical evaluation suggesting high level of low
density lipoprotein cholesterol
Studies suggest that excessive secretion of the
Cortisol hormone leads to an increase in the
cholesterol and triglyceride level in the blood
(Nieman et al., 2015; Starkman, 2013). This results
in elevating the cholesterol build up within the