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

Choice A reason: Hypertension is a common manifestation of Cushing’s syndrome. Excess cortisol increases sodium and water retention, leading to elevated blood pressure. Chronic hypertension contributes to cardiovascular complications in these clients. Choice B reason: Purple striations (striae) on the abdomen, thighs, or breasts are characteristic of Cushing’s syndrome. Cortisol weakens collagen and connective tissue, causing skin thinning and easy tearing. The striae are typically wide and violaceous due to dermal damage. Choice C reason: Moon face is a hallmark sign of Cushing’s syndrome. Cortisol causes redistribution of fat to the face, neck, and trunk, producing the rounded facial appearance. This is a classic physical manifestation used in diagnosis. Choice D reason: Buffalo hump, or fat accumulation on the upper back/neck, is another hallmark sign. Cortisol alters fat metabolism, leading to abnormal fat deposits in specific areas. This feature, along with moon face and truncal obesity, is diagnostic of Cushing’s syndrome. Choice E reason: Tremors are not a typical manifestation of Cushing’s syndrome. While muscle weakness and osteoporosis occur due to protein catabolism, tremors are not directly linked to cortisol excess. Tremors are more associated with neurological disorders or medication side effects.