Hyperaldosteronism & Pheochromocytoma
Med Surg: Endocrine
Hyperaldosteronism
Memory Trick for Aldosterone
AL
Pathophysiology
A • ADDS SODIUM & WATER IN
Hypersecretion of aldosterone hormone from
the adrenal gland. Aldosterone’s function is to
maintain blood pressure by retaining sodium &
water, but also lets potassium out of the kidneys
L • LETS POTASSIUM K+ OUT
Causes
Signs & Symptoms
• Hypertension
• Hypernatremia (sodium OVER 145)
• Polydipsia (extreme thirst)
• Swollen dry tongue
• Increased muscle tone NCLEX TIP
• Hypokalemia (potassium under 3.5)
• ST depression & U waves
• Decreased DTRs
• Constipation & hypoactive bowels
• Polyuria & low urine gravity
MEMORY TRICK
HYPER AL
H- HYPERTENSION (Over 140/90)
Y- YIELDING DTRS & BOWEL SOUNDS (low & slow)
P- POLYURIA & POLYDIPSIA (excess urination & thirst)
E- ECG U WAVE & ST DEPRESSION
R- RAINING URINE (low SG less than 1.005)
A- ADDING SODIUM (Over 145 mEq/L)
L- LOSING POTASSIUM (3.5 mEq/L or Less)
Pheochromocytoma
Primary
Inside Adrenals
Secondary
Outside Adrenals
- Conn’s Syndrome
(benign tumor)
- Genetics
- CHF (congestive
heart failure)
- Renal artery stenosis
Treatment
Goal = lower fluid volume & increase K+
• Potassium supplements
• Spironolactone = potassium sparing diuretic
• Adrenalectomy + steroid treatment
Watch for Addison's CRISIS!
Low Blood pressure that it will KILL!
Nursing Interventions
• Sodium restriction
• Monitor: blood pressure, Intake & Output, potassium &
sodium levels
RARE ADRENAL GLAND TUMOR
Pathophysiology
Tumor in the adrenal gland that can pump out high
amounts of catecholamines, like epinephrine, which can
increase the BP leading to hypertensive crisis - blood
pressure so HIGH it can kill the client! This tumor can be
benign or malignant.
Signs & Symptoms
• High BP with palpitations & chest pain
• Hyperglycemia
• Hypermetabolism
• Other signs from high catecholamines: Sweating, heat
intolerance, tremors, blurred vision, nausea & vomiting
CELLS DARKEN
Nursing Interventions
• Monitor vitals - especially blood pressure!
• No stimulants: smoking & caffeine.
• No changing positions suddenly or rapidly, as it can put
pressure on the tumor & squirt out some catecholamines.
• Give beta blockers as ordered