The nurse is caring for a client with a medical diagnosis of Cushing's syndrome. What would the nurse include in the plan of care?

A. Cluster activities in the morning when well rested. Clients with Cushing's syndrome often suffer from severe muscle wasting and fatigue due to protein catabolism. However, activity should be paced throughout the entire day rather than clustered, which can cause overexertion and cardiovascular strain. Frequent rest periods are necessary to manage the physiological exhaustion associated with chronic hypercortisolism. B. Request a medical prescription for cortisol. Cushing's syndrome is characterized by an endogenous overproduction of cortisol or exogenous steroid excess. Administering additional cortisol would exacerbate the condition and worsen clinical symptoms such as hypertension and hyperglycemia. The goal of treatment is typically to reduce or block cortisol production rather than increase its systemic levels. C. Assess daily weights. Hypercortisolism leads to significant sodium and water retention, resulting in edema and weight gain. Monitoring daily weights is a critical nursing intervention to evaluate fluid status and the effectiveness of treatment. This assessment helps the nurse identify rapid fluid accumulation that could lead to congestive heart failure or pulmonary edema in these patients. D. Teach the client to increase fluid intake. Due to the high risk of fluid volume excess and hypertension, increasing fluid intake is generally contraindicated for clients with Cushing's syndrome. Fluid intake may need to be restricted to prevent worsening edema and cardiovascular complications. The nurse should focus on monitoring intake and output to ensure a balanced fluid volume.