Cushing Syndrome — NCLEX Cheat Sheet
↑ cortisol → ↑ Na, ↓ K, ↑ glucoseAlso known as: high cortisol · too much cortisol · hypercortisolism · Cushing's · steroid excess
Use this quick-reference guide to spot, treat, and prevent Cushing Syndrome on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
⚠️ Causes
- Chronic steroids #1 cause
- Pituitary/adrenal tumor (ACTH)
🩺 Signs
- Moon face, buffalo hump, truncal
- Purple striae, thin skin, bruising
- HTN, weakness, hirsutism
🧪 Labs
- ↑ Na, ↓ K, ↑ glucose
- ↑ cortisol, dexamethasone test
✅ Do
- Low Na, ↑ K, ↑ protein diet
- Infection precautions, skin care
- Taper steroids; never stop abrupt
📚 Cushing Syndrome — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Classic features are moon face, buffalo hump, truncal/central obesity with thin extremities, and purple striae on the abdomen.
- Excess cortisol causes hyperglycemia, hypertension, and sodium and water retention with edema.
- Potassium and calcium are lost, leading to hypokalemia and bone loss/osteoporosis with fracture risk.
- Skin is thin and fragile, bruises easily, and wounds heal slowly; immunosuppression raises infection risk.
- Mood changes, muscle weakness from protein catabolism, and hirsutism in women are common.
Nursing priorities
What to do, in order- Monitor blood glucose, blood pressure, weight, and intake/output, and watch for fluid overload.
- Protect from infection with meticulous hygiene and protect fragile skin from injury and breakdown.
- Provide a diet low in sodium and high in protein, potassium, and calcium.
- Prevent falls and fractures because of osteoporosis and muscle weakness.
- For patients on steroids, never stop the medication abruptly; taper as ordered.
Red flags — report now
Escalate immediately- Report signs of infection promptly, as immunosuppression can mask and worsen infections quickly.
- Never abruptly discontinue chronic corticosteroids; abrupt withdrawal can cause acute adrenal crisis.
- Report severe hypertension, crushing chest pain, or signs of heart failure from fluid overload.
Labs & values
Numbers to know- Cortisol: elevated (normal AM 6-23 mcg/dL)
- Glucose: elevated (normal fasting 70-100 mg/dL)
- Potassium: low (normal 3.5-5.0 mEq/L)
Patient teaching
What patients must know- Take corticosteroids exactly as prescribed and never stop them suddenly.
- Wear medical alert identification and carry information about steroid use.
- Report signs of infection, easy bruising, and significant weight gain or swelling.
❓ Cushing Syndrome: NCLEX FAQs
What are the priority nursing interventions for Cushing Syndrome?
Monitor blood glucose, blood pressure, weight, and intake/output, and watch for fluid overload. Protect from infection with meticulous hygiene and protect fragile skin from injury and breakdown. Provide a diet low in sodium and high in protein, potassium, and calcium. Prevent falls and fractures because of osteoporosis and muscle weakness.
What are the warning signs of Cushing Syndrome a nurse must report?
Report signs of infection promptly, as immunosuppression can mask and worsen infections quickly. Never abruptly discontinue chronic corticosteroids; abrupt withdrawal can cause acute adrenal crisis. Report severe hypertension, crushing chest pain, or signs of heart failure from fluid overload.
What do I need to know about Cushing Syndrome for the NCLEX?
Classic features are moon face, buffalo hump, truncal/central obesity with thin extremities, and purple striae on the abdomen. Excess cortisol causes hyperglycemia, hypertension, and sodium and water retention with edema. Potassium and calcium are lost, leading to hypokalemia and bone loss/osteoporosis with fracture risk. Skin is thin and fragile, bruises easily, and wounds heal slowly; immunosuppression raises infection risk.
What patient teaching is important for Cushing Syndrome?
Take corticosteroids exactly as prescribed and never stop them suddenly. Wear medical alert identification and carry information about steroid use. Report signs of infection, easy bruising, and significant weight gain or swelling.
Quick Tip
Classic features are moon face, buffalo hump, truncal/central obesity with thin extremities, and purple striae on the abdomen.
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