Final answer:
The symptoms of a moon-shaped face and muscle wasting in a client on dexamethasone suggest the development of Cushing's syndrome, a condition associated with prolonged corticosteroid use which presents a constellation of symptoms due to excess cortisol-like effects in the body.
Step-by-step explanation:
The moon-shaped face and muscle wasting in a client taking dexamethasone (Decadron) suggest the development of Cushing's syndrome symptoms due to the side effects of long-term corticosteroid use. Cushing's syndrome symptoms often include a distinctive rounded face, abnormal fat distribution, skin changes, and muscle weakness. Dexamethasone is a potent synthetic corticosteroid that can cause these effects by mimicking the action of the body's natural hormone cortisol when taken in high doses for prolonged periods.
A moon face can arise when excess cortisol causes fat to redistribute to the face, neck, and trunk. Muscle wasting or weakness occurs due to the catabolic effects of excess cortisol, which leads to a decrease in muscle protein synthesis and an increase in muscle protein breakdown. Importantly, while some of the visual symptoms such as moon face are noticeable, other effects of long-term corticosteroid use like increased risk of infections, bone density loss, and altered glucose metabolism require medical monitoring and appropriate management.
The provided content also explains how muscle strength is evaluated by having the patient contract muscles against resistance, and notes the possibility of motor system disorders if there is an overall loss of strength without laterality. This can point towards a global problem with the muscular system unrelated to Cushing's syndrome. Nevertheless, muscle weakness without laterality present in the case of Cushing's syndrome is specific to the catabolic effects on muscles due to excess glucocorticoid exposure.