NUR 211 Final 5 - -Excessive production of catecholamines (epinep...

NUR 211 Final 5

• A rare condition caused by a tumor in the adrenal medulla

-Excessive production of catecholamines (epinephrine and norepinephrine).-

Answer Pheochromocytoma

• What is the most dangerous effect of pheochromocytoma?

Answer Severe hyper- tension

• Triad symptoms of pheochromocytoma

Answer Headache, diaphoresis, palpitations

• Clinical manifestations of pheochromocytoma

Answer -Episodic hypertension -Severe pounding headache -Tachycardia w/ palpitations -Profuse sweating -Unexplained abdominal pain or chest pain

• 5 H's of pheochromocytoma

Answer Hypertension Headache Hyperhidosis (excess sweating) Hypermetabolism Hyperglycemima

• What should be avoided in patients with pheochromocytoma?

Answer Palpation of the abdomen 1 / 4

• What happens when the abdomen is palpated in patients with pheochromocytoma?

Answer A release of catecholamines causes severe hypertension

• Foods to avoid during VMA testing

Answer Coffee and tea (caffeinated or decaffeinat- ed)

Bananas Chocolate Vanilla Aspirin -May alter test results

• Side effects of adrenergic antagonists blockers (doxazosin or phenoxyben- zamine)

Answer Orthostatic hypotension Vertigo Palpitations Sexual Dysfunction

• What surgery is performed for pheochromocytoma?

Answer Adrenalectomy

• Side effects of beta blockers

Answer Bradycardia, AV block, drowsiness, depression, symptoms of CHF, hypotension

• What can be used as an alternative to alpha or beta adrenergic without causing undue

hypotension?

Answer Calcium channel blockers

• adrenal gland hormones 2 / 4

Sugar (Glucocorticoids) Salt (Mineralcorticoids) Sex (Androgens)

• Addison's disease (primary)

Answer Hyposecretion of adrenal cortex hormones

• Primary causes of adrenocortical insufficiency

Answer -Addison's

-Autoimmune response -Gene mutation -TB, infarction, fungal infections, AIDS, metastatic cancer

• Secondary cause of adrenocortical insufficiency

Answer -Lack of pituitary ACTH secretion

-Corticosteroids and androgens are deficient

• Some People Get Cold (Addison's)

Answer Hyponatremia (decreased Sodium) Hyperkalemia (Increased Potassium) Hypoglycemic (Decreased Glucose) Hypercalcemia (Increased Calcium)

• Some People Get Cold (Cushing's)

Answer Hypernatremia (Increased Sodium) Hypokalemia (Decreased Potassium) Hyperglycemic (Increased Glucose) Hypocalcemic (Decreased calcium)

• Clinical manifestations of Addison's

Progressive weakness, fatigue Weight loss, anorexia

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Bronze colored skin, hyperpigmentation Orthostatic hypotension Hyponatremia, hyperkalemia Salt craving N/V, diarrhea, irritability, depression

• Addisonian crisis

Answer Severe hypotension and vascular collapse

• Triggers of Addisonian Crisis

Answer -Stress

-Adrenal surgery -Sudden withdrawal of corticosteroid therapy -Sudden pituitary gland destruction

• Clinical manifestations of Addisonian crisis

Answer Hypotension Tachycardia Dehydration Hyponatremia Hyperkalemia Hypoglycemia Fever Weakness Confusion Shock Circulatory collapse

• Risk Factors for High Risk pregnancy

Answer -Existing health conditions, such as hypertension, diabetes, or HIV+

-A history of prior pregnancy complications -Complications that arise during pregnancy (gestational diabetes or eclampsia) -Being overweight or obese -Carrying more than one fetus -Being 18 years old or younger -Advanced maternal age

• hyperemesis gravidarum

Answer

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