This case study elaborates on the causes of the adrenal tumor. Even though various conditions cause complications in the adrenal gland, this case study focuses on Cushing syndrome. The case study further elaborates on the Cushing syndrome, its signs, and symptoms, how to handle the complication, the causes of this condition, and caution on the patient. The case study constantly refers to refer to a patient named Susan.
The body of a human being needs several hormones in order to operate effectively. Among the hormones, including aldosterone, adrenaline, and cortisol. The gland produces these hormones (Beuschlein et al, 2014). The above-named glands, are produced by the adrenal gland, which is situated on the top side of the human kidney (Bliek, 2017). Tumors affect the adrenal glands. The reason to that is that the glands are not in a position to defend themselves from attack.
The tumors that affect the adrenal glands are led by various conditions. Examples of those conditions include pheochromocytoma, Cushing syndrome, and Conn’s disease. In this case, study, the focus is on Cushing syndrome.
Cushing syndrome is a hormonal situation that affects people in case their amount of cortisol rises below normal. This disorder complicates the life of an individual with various effects. However, the effects seen on the affected people may differ. When this disorder is not controlled it may be so worse that an individual cannot operate normally. On the other hand, there are a group of individuals who at a higher chance of getting this disorder. For example, individuals who are attacked by asthma. These people tend to consume a higher amount of medicine full of stereo. The other group of individuals is those that are attacked by the tumor. The tumor that attacks the adrenal gland or pituitary gland exposes people to Cushing syndrome. The reason is that these people produce a higher amount of cortisol or rather the stereo hormone.
Signs and symptoms of crushing syndrome caused by a benign tumor on the adrenal gland
The amount of excessive cortisol that an affected individual produces determines the crushing syndrome symptoms. However, some symptoms are similar to the entire individual affected by crushing syndrome. Among other symptoms, they include an increase in the weight of the person; this is referred to as obesity, and changes in the appearance of the skin cover of the individual (Nieman et al, 2015). Skin effects include emerging acne on the skin, and deposits of fatty tissues. The sections affected by an increase in fat include the upper back, around the shoulders, and on the face. Apart from that, there are other signs such as the skin that pills out easily. Moreover, other marks may appear on the arms of the individual
However, the gender of the individual also influences the signs and symptoms of crushing syndrome. For instance, female victims may encounter inconsistency or lack of getting menstrual periods, emerging of hirsutism, which is the appearance overweight on the face. On the other hand, males experience different symptoms as compared to their female counterparts (Carney et al, 2015). These signs include low libido level, lack of erection or malfunction during the erection time and lastly encountering infertility problems.
Other symptoms occur which include a headache, impaired growth in young people, development of anxiety, and continuous development of fractures that are due to weak or no bones. There is also weakness in muscles, which makes the victim shun away from walking. The emotions of the individual are also not in control as they can makes decisions faster and in a premature way.
Causes of Cushing Syndrome
The crushing syndrome is mainly caused by the cortisol hormone (Pivonello, et al, 2015). The point where this hormone cause this is when it is produced in more amount than the normal amount. However, this hormone is important in the body of a human being. For example, this hormone controls the pressure of the blood oranges in the body. Adrenal glands are the ones that are always responsible for the production of the hormone (Di Dalmazi et al, 2014). Apart from the above-named function, the hormone is also responsible for ensuring the reduction of stress in an individual. Digestion also needs this hormone to ensure energy-giving food is digested effectively. The more production of this hormone, however, leads to some complications like crushing syndrome.
The patient Susan shows some common signs of crushing syndrome such as obesity and increased BMI. These signs are seen in every individual who is infected with this syndrome from the tumor. However, there are vital signs seen in the patient such as severe injuries, and the normal running of the body fluid is not as usual. The other thing is the development of a urinary complications. The result seen is as stated earlier that individuals may vary in how the signs and symptoms appear in the body. The reason that may be applied to Susan is the gender; the female sometimes develops signs that may not be the same as those of males. Apart from the vital symptoms named above, the other thing that can be focused on is the change in pressure (Fraga et al, 2015). The blood pressure of the affected people varies. This depends on how fatal the crushing syndrome has reached. Susan has been consuming carbohydrates every time she goes to work and that affects how the individual operates. The urine amount passed by the victim is at a normal rate of one who is affected by crushing syndrome from the tumor.
Health care needs of a patient suffering from the disorder
Before the removal of an adrenal tumor, the patient needs much care mostly from the family members. Two hours before the surgery is undertaken, the patient needs some preparation equipment. The medical practitioner mainly illustrates these care needs. Talk about the case of Susan, she needs to arm herself with a kit that contains phosphor soda. Another important care need that should be checked on Susan is to ensure that she only consumes liquid foods. These may include tea, soda, or rather coffee. Other sugary foods such as oranges, milk, or cream should be avoided by the undertaking of the surgery.
The vital complications that may be experienced by the patient Susan should be addressed by continuously consulting a medical practitioner. The vital signs may cause frustration to the patient to the point of causing stress. Another thing that should be taken into consideration is reducing corticosteroid drugs. The reason is that these drugs may bring the levels of cortisol down to an abnormal level hence having a good health condition.
Susan should reach the operation place two hours before the time scheduled for the surgery. This provides ample time for the preparation of surgery. Close family members should accompany the patient. However, these members are not allowed to enter the theatre room. Constant update is given to them to ensure no anxiety rise in them.
After the surgery, a comprehensive healing procedure is required for the patient to recover well. For instance, the family members while at the hospital can assist Susan. What matters in the period of recovery is how the patient showers, the type of food that the patient takes and the drugs that he or she takes (Tabarin et al, 2015). On the first day of the removal of the tumor, the patient should still feed on liquid foods (Lacroix et al, 2016). However, some complications come because of the operation. For instance, there may be a complication in the throat and some severe pain.
. Cautions should be taken while handling the affected individual. To ensure that the disease is controlled, the earlier treatment is recommended to reduce severe effects. The continuous suffering of the patient may lead to stress for the individual. The stress leads to memory loss and the affected individual may tend to be forgetting very first. Some people, who become the victims of this disorder, may feel isolated at times from the members of society. For this reason, it is recommended that society and members of the family do not ignore an individual. The cooperation of the affected person and the continuous support makes the patient feel good. No matter how the situation pains being together means a lot to the person (Raff et al, 2015).
Apart from that, it is recommended that the individual get some qualified people other than the nurses that provide health services. These people have a task to ensure that the recovery period is well undertaken. Home members may not provide professional services hence people who have skills in this can be hired to assist the individual. When a person starts feeling the signs named above he or she should rush to the doctor for intervention. This enables early handling of the disorder.
In conclusion, Cushing syndrome is quite stressful. It mainly gets its way through to one body through the condition of excessive hormones. The hormone is usually referred to as cortisol (Salenave et al, 2015). The excessive production of cortisol leads to a bigger hump in the individual’s body parts such as the shoulder. Another effect of this disorder is the loss of bones, high blood pressure, and development of type two diabetes among others.
Beuschlein, F., Fassnacht, M., Assié, G., Calebiro, D., Stratakis, C. A., Osswald, A., … & Schaak, K. (2014). Constitutive activation of PKA catalytic subunit in adrenal Cushing’s syndrome. New England Journal of Medicine, 370(11), 1019-1028.
Bliek, J. S. (2017). A Case of Cushing’s Syndrome in a Child, due to Adrenocortical Adenoma. Paediatrica Indonesiana, 14(7-8), 123-7.
Carney, J. A., Lyssikatos, C., Lodish, M. B., & Stratakis, C. A. (2015). Germline PRKACA amplification leads to Cushing syndrome caused by 3 adrenocortical pathologic phenotypes. Human pathology, 46(1), 40-49.
Di Dalmazi, G., Vicennati, V., Garelli, S., Casadio, E., Rinaldi, E., Giampalma, E., … & Pasquali, R. (2014). Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing’s syndrome: a 15-year retrospective study. The lancet Diabetes & endocrinology, 2(5), 396-405.
Fraga, B., Franco, C., Vaz, S., Gomes, F., Sa-Fernandes, M., Pinheiro, J., … & Anselmo, J. (2015). Cushing Syndrome Due to Primary Pigmented Nodular Adrenal Disease in Three Related Adolescent Girls With Carney Complex. Journal of Endocrinology and Metabolism, 5(4), 261-266.
Lacroix, A., Feelders, R. A., Stratakis, C. A., & Nieman, L. K. (2015). Cushing’s syndrome. The lancet, 386(9996), 913-927.
Melmed, S. (2016). Williams textbook of endocrinology. Elsevier Health Sciences.
Nieman, L. K. (2015). Cushing’s syndrome: update on signs, symptoms and biochemical screening. European journal of endocrinology, 173(4), M33-M38.
Nieman, L. K., Biller, B. M., Findling, J. W., Murad, M. H., Newell-Price, J., Savage, M. O., & Tabarin, A. (2015). Treatment of Cushing’s syndrome: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 100(8), 2807-2831.
Pivonello, R., De Leo, M., Cozzolino, A., & Colao, A. (2015). The treatment of Cushing’s disease. Endocrine reviews, 36(4), 385-486.
Raff, H., Auchus, R. J., Findling, J. W., & Nieman, L. K. (2015). Urine free cortisol in the diagnosis of Cushing’s syndrome: is it worth doing and, if so, how?. The Journal of Clinical Endocrinology & Metabolism, 100(2), 395-397.
Salenave, S., Bernard, V., Do Cao, C., Guignat, L., Bachelot, A., Leboulleux, S., … & Santulli, P. (2015). Ovarian macrocysts and gonadotrope–ovarian axis disruption in premenopausal women receiving mitotane for adrenocortical carcinoma or Cushing’s disease. European journal of endocrinology, 172(2), 141-149.