Cushing's Syndrome: Susan Summers, A 40-Year-Old Casual Worker

Susan Summers, a 40-year-old casual worker, admitted to the hospital for laparoscopic right adrenalectomy. Mother of three children and she drink a bottle of wine every night. Susan is obese at 90 kg; her BMI is 36 kg/m2. She has a medical history of type 2 diabetes and she has a benign tumour on her right adrenal gland which caused by her Cushing’s syndrome.

Firstly, according to a clinical study, Cushing’s syndrome is a chronic excessive exposure of glucocorticoids of the body’s tissues of the high level of the hormone cortisol, also known as hypercortisolism. In normal adrenal pathophysiology, the production of hormone cortisol produced within adrenal gland by the zona fasciculata of the adrenal cortex. Adrenal glands located in the superior
In addition, her current diagnosis also effects on her presenting conditions such as type 2 diabetes and obesity. However, in Cushing’s syndrome, metabolic syndrome has the same features such as diabetes mellitus, hypertension, and obesity. Since Susan diagnosed with type 2 diabetes is commonly associated with Cushing’s syndrome, as result of excessive in glucocorticoid, can induce stimulation of gluconeogenesis and inhibit of insulin sensitivity in the liver and the skeletal muscles as these plays the most vital responsible for glucose metabolism (Pivonello, et al., 2010). Cushing’s syndrome related to obesity caused by amass excessive corticosteroid in adipose tissue in the face, cervical areas and trunk
During the postoperative period, the majority of the patient may have the postoperative complication such as cardiac compromise (hypertension and hypotension), altered respiratory pattern (hypoxaemia), and altered neurological status (Rose, & Clarke, 2010). Postoperative complications such as bleeding, haematoma, decrease urine output and abdominal tenderness (Bergamini, Martellucci, Tozzi, & Valeri, 2011). In this case study, Susan is hypothermic resulted from post-surgery due to an inadvertent hypothermia caused by environmental such as heat lost due to prolonged exposure of organs during surgery and anaesthesia effect that cause thermoregulatory vasoconstriction (Kare, & Shneiderman, 2001). In addition, the majority of diabetic patients experience thermogenic abnormalities because of degeneration or damage of nerve (Chao, et al., 2010). She also tachycardic refers to the heart rate beats more than 100 beats in minutes. For example, influencing factor of tachycardia arises such as trauma, a decrease in blood volume, anaemia, infection, shock, fever and pain. Susan develop tachypnoea after surgery is the result of when she is recovering from post general anaesthesia, and she is obese which altered her respiratory function. In addition, she also encounters poor urine output is 5ml in past hour. Altered urinary function after surgery expected unrelatedly of fluid intake. The normal urine output is approximately