Adrenalectomy
- General information
- Removal of one or both adrenal glands
- Indications
- Tumors of adrenal cortex (Cushing's syndrome, hyperaldosteronism) or medulla (pheochromocytoma)
- Metastatic cancer of the breast or prostate
- Nursing interventions: preoperative
- Provide routine pre-op care.
- Correct metabolic/cardiovascular problems.
- Pheochromocytoma: stabilize blood pressure.
- Cushing's syndrome: treat hyperglycemia and protein deficits.
- Primary hyperaldosteronism: treat hypertension and hypokalemia.
- Administer glucocorticoid preparation on the morning of surgery as ordered to prevent acute adrenal insufficiency.
- Nursing interventions: postoperative
- Provide routine post-op care.
- Observe for hemorrhage and shock.
- Monitor vital signs, I&O.
- Administer IV therapy and vasopressors as ordered.
- Prevent infections (suppression of immune system makes clients especially susceptible).
- Encourage coughing and deep breathing to prevent respiratory infection.
- Use meticulous aseptic technique during dressing changes.
- Administer cortisone or hydrocortisone as ordered to maintain cortisol levels.
- Provide general care for the client with abdominal surgery.
- Provide client teaching and discharge planning concerning
- Self-administration of replacement hormones
- Bilateral adrenalectomy: lifelong replacement of glucocorticoids and mineralocorticoids
- Unilateral adrenalectomy: replacement therapy for 6-12 months until the remaining adrenal gland begins to function normally
- Signs and symptoms of adrenal insufficiency
- Importance of follow-up care
Monday, May 19, 2008
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endocrine disorder
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This entry was posted on Monday, May 19, 2008
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endocrine disorder
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1 comments:
hello to Angelite Nurses Thank you for this column.. More power. BSN-4b{2009)
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