A nurse receives hand-off report about a patient admitted with a diagnosis of Cushing syndrome. Which findings would the nurse anticipate when the client is assessed?

Choice A rationale Chronically low blood pressure and dehydration are not characteristic of Cushing syndrome. Cushing syndrome is caused by prolonged exposure to high levels of cortisol. Cortisol, a glucocorticoid, increases sodium and water retention and potassium excretion. This fluid retention leads to increased blood volume and hypertension, not low blood pressure. The patient would typically have fluid overload, not dehydration. Choice B rationale Decreased axillary and pubic hair, known as sexual hair, is not a typical finding in Cushing syndrome. High cortisol levels can lead to excess androgen production, which in females may result in hirsutism, or excessive growth of male-pattern hair, including on the face, chest, and back. Decreased sexual hair is more commonly associated with conditions like Addison's disease or hypopituitarism, where there is a deficiency of adrenal hormones. Choice C rationale Purplish-red abdominal striae and a "moon face" are classic signs of Cushing syndrome. The high cortisol levels cause collagen breakdown, leading to thin, fragile skin that easily tears, forming these striae. The fat redistribution caused by cortisol excess leads to central obesity, a rounded or "moon" face, and a buffalo hump on the upper back. This combination of physical changes is pathognomonic for the condition. Choice D rationale Bulging of the eyes, or exophthalmos, and intolerance to heat are classic signs of hyperthyroidism, specifically Graves' disease. These symptoms are caused by an autoimmune process where antibodies stimulate the thyroid gland to produce excess thyroid hormones. They are not associated with Cushing syndrome, which is a disorder of the adrenal cortex and its regulation.