The manager observes a staff nurse instruct a patient with Cushing syndrome about the risk for infection. For which statement should the manager correct the nurse?
1. "Epidermal hypertrophy restricts macrophage activity."
2. "Cortisol affects protein synthesis."
3. "Cortisol inhibits collagen synthesis."
4. "The resulting edema impairs blood flow to tissues."
Correct Answer: 1
Glucocorticoid excess inhibits fibroblasts, resulting in loss of collagen and connective tissue. Thinning of skin, poor wound healing, and frequent skin infections result. Macrophage activity is not a related action. Increased cortisol affects protein synthesis, causing delayed wound healing, and inhibits collagen formation, which results in epidermal atrophy, further inhibiting resistance to infection. Impaired blood flow to edematous tissue results in altered cellular nutrition, which increases the potential for infection.
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