Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 8 Endocrine System^353



  • Weigh the patient daily.

  • Explain to patient:

    • Thirst, dry mucous membranes are caused by low sodium. Allow sips of
      water, ice chips.




Pheochromocytoma


WHAT WENT WRONG?


A tumor on the adrenal medulla secretes excessive amounts of epinephrine and
norepinephrine.


PROGNOSIS


Patients who are diagnosed and treated early can expect a normal life with
closefollow-up, if the tumor is benign. Patients can expect a limited prognosis if
the tumor is malignant. Metastasis may develop at any time. The patient’s hyper-
tension often resolves with removal of the tumor, but may recur later in life.


HALLMARK SIGNS AND SYMPTOMS



  • Uncontrollable hypertension as a result from increased epinephrine and nor-
    epinephrine

  • Headaches as a result of hypertension

  • Palpitations and tachycardia due to increased production of catecholamines

  • Dilated pupils from increased production of epinephrine and norepinephrine


INTERPRETING TEST RESULTS



  • Presences of catecholamines in serum.

  • Increased catecholamines, metanephrines, and vanillylmandelic acid (VMA)
    in 24-hour urine collection.

  • Presence of adrenal tumor shown in CT scan.


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