Hyperaldosteronism

Assessment

Nursing Diagnosis

Goals/Expected Outcomes

Nursing Interventions

Rationale

Evaluation

Patient presents with persistent hypertension, headache, blurred vision, and increased blood pressure readings.

Decreased Cardiac Output related to hypertension and electrolyte imbalance as evidenced by elevated BP (e.g., 160/100 mmHg), palpitations, and headache.

– Patient’s blood pressure will be maintained within normal limits. 

– Patient will verbalize understanding of hypertension management. 

– Patient will adhere to prescribed antihypertensive medications.

1. Monitor blood pressure, heart rate, and signs of hypertensive crisis. 

2. Administer prescribed antihypertensive medications (e.g., spironolactone, calcium channel blockers). 

3. Educate the patient on lifestyle modifications (low-sodium diet, weight control). 

4. Monitor for complications like left ventricular hypertrophy and heart failure. 

5. Prepare the patient for surgical adrenalectomy if indicated.

1. Prevents complications from sustained hypertension. 

2. Spironolactone blocks aldosterone effects and helps control BP. 

3. Lifestyle changes enhance BP control and prevent worsening of symptoms. 

4. Early detection prevents cardiac complications. 

5. Surgery may be necessary for aldosterone-secreting tumors (Conn’s syndrome).

– Patient maintains stable BP without complications. 

– Patient verbalizes adherence to lifestyle and medication regimen.

Patient has hypokalemia as evidenced by muscle weakness, fatigue, leg cramps, and ECG changes.

Impaired water- electrolyte Imbalance related to excessive aldosterone secretion as evidenced by serum potassium <3.5 mEq/L and muscle weakness.

– Patient’s potassium levels will return to normal (3.5–5.0 mEq/L). 

– Patient will demonstrate knowledge of potassium-rich dietary sources. 

– Patient will remain free from cardiac arrhythmias.

1. Monitor serum potassium levels and ECG for arrhythmias. 

2. Administer potassium supplements as prescribed. 

3. Encourage potassium-rich foods (bananas, oranges, spinach). 

4. Educate about the importance of medication adherence (spironolactone to conserve potassium). 

5. Monitor urinary output and renal function.

1. Hypokalemia can cause life-threatening arrhythmias. 

2. Corrects potassium deficit and prevents complications. 

3. Helps maintain normal potassium levels naturally. 

4. Spironolactone prevents potassium loss by blocking aldosterone. 

5. Ensures potassium is not lost excessively through urine.

– Patient maintains normal potassium levels. 

– No signs of arrhythmias or muscle weakness. 

– Patient adheres to dietary recommendations.

Patient reports excessive thirst (polydipsia) and frequent urination (polyuria).

Inadequate Fluid Volume related to excessive urinary loss due to aldosterone excess as evidenced by increased urine output and dehydration signs.

– Patient’s fluid balance will be maintained. 

– Patient will report decreased thirst and normal urine output. 

– Patient’s serum sodium and potassium levels will remain within normal limits.

1. Monitor intake and output, daily weights, and signs of dehydration. 

2. Encourage adequate fluid intake unless contraindicated. 

3. Administer IV fluids (e.g., isotonic saline) if severe dehydration occurs. 

4. Educate patient on fluid replacement strategies. 

5. Monitor serum sodium levels to prevent hypernatremia.

1. Early detection of dehydration prevents complications. 

2. Prevents dehydration-related symptoms. 

3. IV fluids help restore intravascular volume. 

4. Prevents excessive thirst and compensatory fluid loss. 

5. Prevents sodium imbalances that can worsen symptoms.

– Patient maintains normal hydration. 

– No signs of excessive thirst or dehydration. 

– Serum sodium remains stable.

Patient expresses anxiety about condition and potential need for surgery.

Excessive Anxiety related to uncertainty about disease and treatment as evidenced by patient verbalizing concerns about long-term health and surgery.

– Patient will verbalize reduced anxiety. 

– Patient will demonstrate understanding of the condition and treatment. 

– Patient will actively participate in care decisions.

1. Assess anxiety level and provide emotional support. 

2. Educate the patient on hyperaldosteronism, treatment options, and expected outcomes. 

3. Encourage expression of fears and concerns. 

4. Provide information on surgical adrenalectomy if indicated. 

5. Offer relaxation techniques (deep breathing, guided imagery).

1. Helps identify the patient’s emotional needs. 

2. Increases understanding and reduces fear of the unknown. 

3. Promotes coping and psychological well-being. 

4. Helps patient make informed treatment decisions. 

5. Helps reduce stress and its physiological effects.

– Patient verbalizes reduced anxiety. 

– Patient demonstrates understanding of condition. 

– Patient actively participates in treatment.

Patient reports difficulty engaging in daily activities due to muscle weakness and fatigue.

Activity Intolerance related to hypokalemia-induced muscle weakness as evidenced by patient reporting fatigue and inability to perform normal activities.

– Patient will report improved energy levels. 

– Patient will tolerate activities of daily living without excessive fatigue. 

– Patient will participate in gradual activity progression.

1. Assess muscle strength, fatigue levels, and ability to perform daily activities. 

2. Encourage rest periods between activities. 

3. Provide a potassium-rich diet and encourage adherence to medications. 

4. Assist with activities as needed but encourage independence. 

5. Monitor for muscle cramps, arrhythmias, and weakness progression.

1. Identifies severity of fatigue and weakness. 

2. Prevents overexertion and worsening of symptoms. 

3. Correcting potassium levels restores muscle function. 

4. Promotes independence while ensuring safety. 

5. Early detection prevents severe complications.

– Patient tolerates daily activities without excessive fatigue.

 – Muscle strength improves.

 – No signs of severe weakness or arrhythmias.