The nurse is aware that the following is the most common cause of hyperaldosteronism?
A. Excessive sodium intake
B. A pituitary adenoma
C. Deficient potassium intake
D. An adrenal adenoma
Correct Answer: D. An adrenal adenoma
An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the second most frequent cause. Excess production of aldosterone is referred to as hyperaldosteronism. Hyperaldosteronism can initially present as mild or severe to refractory hypertension but can often go undiagnosed. Aldosterone secretion is independent of sodium and potassium intake as well as of pituitary stimulation.
Option A: Aldosterone is the primary mineralocorticoid in the body. Aldosterone acts on the epithelial sodium channels (ENaC) in the collecting tubules and causes sodium reabsorption. The increased reabsorption of sodium leads to hypertension and volume expansion. Sodium reabsorption, volume expansion, and increased peripheral vascular resistance are the causative factors for hypertension in aldosteronism.
Option B: Primary hyperaldosteronism is due to the excess production of the adrenal gland, more specifically the zona glomerulosa. It can present more commonly as a primary tumor in the gland known as Conn syndrome or bilateral adrenal hyperplasia.
Option C: Sodium reabsorption creates a negative potential in the tubular lumen and, in turn, causes movement of cations (primarily potassium and hydrogen ions) into the tubular lumen to maintain electrical neutrality, resulting in hypokalemia and metabolic alkalosis. Symptoms are usually due to moderate to severe high blood pressure or secondary to hypokalemia. High blood pressure can cause headaches, dizziness, vision problems, chest pain, and dyspnea.
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