Page 1387 - Saunders Comprehensive Review For NCLEX-RN

c. Excess secretion of aldosterone causes
sodium and water retention and
potassium excretion, leading to
hypertension and hypokalemic
alkalosis.
2. Assessment
a. Symptoms related to hypokalemia,
hypernatremia, and hypertension
b. Headache, fatigue, muscle weakness
c. Cardiac dysrhythmias
d. Paresthesias, tetany
e. Visual changes
f. Glucose intolerance
g. Elevated serum aldosterone levels
3. Interventions
a. Monitor vital signs, particularly blood
pressure.
b. Monitor potassium and sodium levels.
c. Monitor intake and output and urine
for specific gravity.
d. Monitor for hyperkalemia, particularly
for clients with impaired renal function
or excessive potassium intake, because
potassium-retaining diuretics and
aldosterone antagonists may be
prescribed to promote fluid balance
and control hypertension.
e. Administer potassium supplements as
prescribed to treat hypokalemia;
clients taking potassium-retaining
diuretics and potassium
supplementation are at risk for
hyperkalemia.
f. Prepare the client for adrenalectomy.
g. Maintain sodium restriction, if
prescribed, preoperatively.
h. Administer glucocorticoids
preoperatively, as prescribed, to
prevent adrenal hypofunction and
prepare for stress of surgery.
i. Monitor the client for adrenal
insufficiency postoperatively.
j. Instruct the client regarding the need for
glucocorticoid therapy following
adrenalectomy.
k. Instruct the client about the need to
wear a MedicAlert bracelet.
E. Pheochromocytoma

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