Which instruction would be appropriate to delegate to assistive personnel for a hospitalized patient with suspected Cushing disease?

Which instruction would be appropriate to delegate to assistive personnel for a hospitalized patient with suspected Cushing disease?

• A. Remind the patient to avoid drinking coffee and changing positions suddenly.
• B. Encourage the patient to drink caffeinated beverages regularly.
• C. Allow unrestricted caffeine and rapid position changes.
• D. Encourage frequent spicy foods.

Answer: (A)

In suspected Cushing disease, reducing factors that raise blood pressure and provoke agitation is important because excess cortisol often comes with hypertension, edema, and metabolic instability. Caffeine stimulates the sympathetic nervous system, which can raise blood pressure and heart rate and worsen sleep and anxiety—unhelpful in a patient already at cardiovascular risk from cortisol excess. Having assistive personnel remind the patient to avoid coffee and other caffeinated drinks helps minimize these fluctuations and supports stability and rest. Keeping in mind safety with position changes, moving slowly and avoiding rapid changes helps prevent dizziness or falls that can occur with edema, weakness, or electrolyte disturbances seen in cortisol excess. The other choices would either promote symptoms (regular caffeinated intake), or introduce unnecessary risks (unrestricted caffeine with rapid changes) or focus on unrelated items (spicy foods) that don’t address the hemodynamic and safety concerns of suspected Cushing disease.

In suspected Cushing disease, reducing factors that raise blood pressure and provoke agitation is important because excess cortisol often comes with hypertension, edema, and metabolic instability. Caffeine stimulates the sympathetic nervous system, which can raise blood pressure and heart rate and worsen sleep and anxiety—unhelpful in a patient already at cardiovascular risk from cortisol excess. Having assistive personnel remind the patient to avoid coffee and other caffeinated drinks helps minimize these fluctuations and supports stability and rest.

Keeping in mind safety with position changes, moving slowly and avoiding rapid changes helps prevent dizziness or falls that can occur with edema, weakness, or electrolyte disturbances seen in cortisol excess. The other choices would either promote symptoms (regular caffeinated intake), or introduce unnecessary risks (unrestricted caffeine with rapid changes) or focus on unrelated items (spicy foods) that don’t address the hemodynamic and safety concerns of suspected Cushing disease.