A client with Cushing's disease is admitted after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem?

A client with Cushing's disease is admitted after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem?

• A. Nervousness
• B. Infection
• C. Concern about appearance
• D. Inability to care for self

Answer: (B)

The main idea is that high cortisol from Cushing's disease suppresses the immune system and slows wound healing. After a stab wound, this immunosuppression drastically raises the risk of infection and sepsis, and the patient may not show typical infection signs right away because the inflammatory response is blunted. Because infection can progress quickly to life-threatening complications, preventing infection and closely monitoring for any signs of infection is the highest priority. This includes strict aseptic wound care, timely antibiotic therapy if ordered, and careful monitoring of temperature and wound status, along with maintaining good glycemic control since hyperglycemia further impairs immune function. While anxiety, concerns about appearance, and independence are important, they are not the most immediate life-threatening concerns in this acute scenario.

The main idea is that high cortisol from Cushing's disease suppresses the immune system and slows wound healing. After a stab wound, this immunosuppression drastically raises the risk of infection and sepsis, and the patient may not show typical infection signs right away because the inflammatory response is blunted. Because infection can progress quickly to life-threatening complications, preventing infection and closely monitoring for any signs of infection is the highest priority. This includes strict aseptic wound care, timely antibiotic therapy if ordered, and careful monitoring of temperature and wound status, along with maintaining good glycemic control since hyperglycemia further impairs immune function. While anxiety, concerns about appearance, and independence are important, they are not the most immediate life-threatening concerns in this acute scenario.