A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize which of the following are manifestations of Cushing's syndrome? (Select all that apply)

Choice A reason: Tremors are not a typical manifestation of Cushing’s syndrome, which results from excess cortisol. Tremors are more associated with hyperthyroidism or neurological disorders, not cortisol-induced metabolic changes, making this an incorrect symptom for this condition. Choice B reason: Purple striations occur in Cushing’s syndrome due to excess cortisol weakening connective tissue, causing skin thinning and fragile blood vessels. This leads to characteristic purple stretch marks, particularly on the abdomen, a hallmark of chronic hypercortisolism. Choice C reason: Buffalo hump, a fat pad on the upper back, is a classic sign of Cushing’s syndrome. Excess cortisol causes abnormal fat distribution, depositing adipose tissue in specific areas, altering body shape, and reflecting the metabolic impact of hypercortisolism. Choice D reason: Hypertension in Cushing’s syndrome results from cortisol’s mineralocorticoid effects, increasing sodium retention and blood volume. This elevates blood pressure, a common cardiovascular manifestation, contributing to the increased risk of heart disease in patients with chronic cortisol excess. Choice E reason: Moon face, a rounded facial appearance, is caused by cortisol-induced fat redistribution in Cushing’s syndrome. Excess cortisol deposits fat in the cheeks and temporal areas, altering facial contours, a distinctive sign of this endocrine disorder in affected individuals.