When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect:
A. Blood pressure of 130/70 mm Hg.
B. A blood glucose level of 130 mg/dl.
C. Bradycardia.
D. A blood pressure of 176/88 mm Hg.
Correct Answer: D. A blood pressure of 176/88 mm Hg.
Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. It isn’t associated with the other options. Tumors secrete only norepinephrine usually presents with sustained hypertension. Norepinephrine and epinephrine secreting tumor present with paroxysmal hypertension. Only epinephrine can cause hypotension instead of hypertension.
Option A: Pheochromocytoma can be asymptomatic and diagnosed by further workup of an adrenal incidentaloma. It can present with vague symptoms like a headache (50%), palpitations (60%), and diaphoresis (50%) that can lead to a paroxysmal hypertensive crisis due to increased catecholamine production.
Option B: Other associated symptoms include pallor (40%), nausea (40%), tremor, trembling, fatigue (40%), anxiety, fever, pain, and flushing (20%). Characteristically, these symptoms are paroxysmal and may be precipitated by abdominal exertion, such as heavy lifting or performing the Valsalva maneuver. Almost 90% of the population with pheochromocytoma has hypertension.
Option C: Due to the release of catecholamine, there is an increase in heart rate, systemic vascular resistance, inotropic effect, and a decrease in venous compliance. In pheochromocytoma, there is orthostatic hypotension as it is a volume-depleted type of hypertension.
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