Page 1389 - Saunders Comprehensive Review For NCLEX-RN

infarction.
c. Instruct the client not to smoke, drink
caffeine-containing beverages, or
change position suddenly.
d. Prepare to administer α-adrenergic
blocking agents and β-adrenergic
blocking agents as prescribed to
control hypertension. α-Adrenergic
blocking agents are started 7 to 10 days
before β-adrenergic blocking agents.
e. Monitor serum glucose level.
f. Promote rest and a nonstressful
environment.
g. Provide a diet high in calories,
vitamins, and minerals.
h. Prepare the client for adrenalectomy.

For the client with pheochromocytoma,

avoid stimuli that can precipitate a hypertensive
crisis, such as increased abdominal pressure and
vigorous abdominal palpation.
F. Adrenalectomy

1. Description (Box 46-9)
2. Preoperative interventions
a. Monitor electrolyte levels and correct
electrolyte imbalances.
b. Assess for dysrhythmias.
c. Monitor for hyperglycemia.
d. Protect the client from infections.
e. Administer glucocorticoids as
prescribed.
3. Postoperative interventions
a. Monitor vital signs.

b. Monitor intake and output; if

the urinary output is lower than
30 mL/hr, notify the PHCP or
nephrologist, because this may result
in acute kidney injury and indicate
impending shock.
c. Monitor weight daily.
d. Monitor electrolyte and serum glucose
levels.
e. Monitor for signs of hemorrhage and
shock, particularly during the first 24

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