If a client with Cushing syndrome has an increased cortisol level, which condition should the nurse monitor for?

In the case of a client with Cushing syndrome presenting with an increased cortisol level, monitoring for hypernatremia is particularly crucial. Cushing syndrome is characterized by excessive cortisol production, which can lead to fluid retention and an increase in sodium levels in the body. Elevated cortisol enhances the reabsorption of sodium in the kidneys, which subsequently can result in hypernatremia.

Hypernatremia can present with symptoms such as increased thirst, confusion, muscle twitching, and in severe cases, seizures. Therefore, it is important for the nurse to closely monitor electrolyte levels and assess the patient's overall fluid balance in this context to prevent complications related to high sodium levels. Monitoring for other potential complications like hypoglycemia, hypovolemia, or hyperkalemia wouldn't be as pertinent in this situation, as high cortisol levels typically lead to opposite effects, primarily related to increased sugar and sodium levels in the bloodstream.