Pheochromocytoma

  1. General information
    1. Functioning tumor of the adrenal medulla that secretes excessive amounts of epinephrine and norepinephrine
    2. Occurs most commonly between ages 25-50
    3. May be hereditary in some cases
  2. Assessment findings
    1. Severe headache, apprehension, palpitations, profuse sweating, nausea
    2. Hypertension, tachycardia, vomiting, hyperglycemia, dilation of pupils, cold extremities
    3. Diagnostic tests
      1. Increased plasma levels of catecholamines; elevated blood sugar; glycosuria
      2. Elevated urinary catecholamines and urinary vanillylmandelic acid (VMA) levels
      3. Presence of tumor on x-ray
  3. Nursing interventions
    1. Monitor vital signs, especially blood pressure.
    2. Administer medications as ordered to control hypertension.
    3. Promote rest; decrease stressful stimuli.
    4. Monitor urine tests for glucose and acetone.
    5. Provide high-calorie, well-balanced diet; avoid stimulants such as coffee, tea.
    6. Provide care for the client with an adrenalectomy (see below) as ordered; observe postadrenelectomy client carefully for shock due to drastic drop in catecholamine level.
    7. Provide client teaching and discharge planning: same as for adrenalectomy.

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