Pheochromocytoma

Assessment

Nursing Diagnosis

Goals/Expected Outcomes

Interventions

Rationale

Evaluation

Patient presents with hypertension, palpitations, headaches, excessive sweating, and anxiety. Laboratory results show elevated catecholamines.

Risk for Hypertensive Crisis related to excessive catecholamine secretion as evidenced by severe hypertension, palpitations, and headaches.

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

– Patient will report reduced episodes of palpitations and headaches. 

– Patient will avoid triggers that exacerbate symptoms.

1. Monitor blood pressure and heart rate frequently. 

2. Administer prescribed antihypertensive medications (alpha-blockers and beta-blockers). 

3. Educate patient on avoiding triggers like stress, caffeine, and strenuous activity. 

4. Prepare patient for surgical removal of the tumor (adrenalectomy) if indicated. 

5. Monitor for signs of hypertensive crisis (severe headache, visual disturbances, seizures).

1. Early detection of hypertensive episodes helps prevent complications. 

2. Controls blood pressure and prevents complications. 

3. Reduces catecholamine surges and symptom exacerbation. 

4. Definitive treatment to remove the source of excessive catecholamine secretion. 

5. Prevents life-threatening complications like stroke or myocardial infarction.

– Patient maintains stable blood pressure. 

– Patient reports reduced palpitations and headaches.

 – Patient adheres to lifestyle modifications.

Patient reports episodes of anxiety, excessive sweating, and restlessness. Patient appears nervous and agitated.

Anxiety related to catecholamine excess as evidenced by restlessness, tachycardia, and diaphoresis.

– Patient will verbalize reduced anxiety and use coping strategies. 

– Patient’s vital signs will remain stable.

 – Patient will participate in relaxation techniques.

1. Assess level of anxiety and provide a calm environment. 

2. Teach relaxation techniques (deep breathing, guided imagery). 

3. Administer prescribed anxiolytics if indicated. 

4. Reassure the patient and provide psychological support. 

5. Educate the patient on the physiological cause of symptoms.

1. Minimizes stress, which can trigger catecholamine release. 

2. Helps the patient manage anxiety episodes. 

3. Controls severe anxiety and autonomic symptoms. 

4. Reduces fear and emotional distress. 

5. Enhances understanding and reduces uncertainty.

– Patient verbalizes reduced anxiety. 

– Patient demonstrates relaxation techniques.

 – Vital signs remain within normal range.

Patient reports headaches, dizziness, and episodes of fainting.

Risk for Decreased Cardiac Output related to excessive catecholamine secretion as evidenced by tachycardia, hypertension, and palpitations.

– Patient will maintain stable cardiac function with normal heart rate and blood pressure.

 – Patient will remain free from syncope and dizziness.

 – Patient will adhere to prescribed medications and treatments.

1. Monitor ECG for arrhythmias and signs of myocardial strain. 

2. Assess for signs of heart failure (dyspnea, edema, chest pain). 

3. Administer beta-blockers or calcium channel blockers as prescribed. 

4. Encourage adequate hydration and sodium intake (if not contraindicated). 

5. Educate the patient about the importance of adherence to treatment.

1. Detects potential cardiac complications early. 

2. Prevents worsening of cardiac function. 

3. Helps regulate heart rate and blood pressure. 

4. Prevents dehydration-related hypotension. 

5. Ensures effective symptom management.

– Patient remains hemodynamically stable. 

– No episodes of dizziness or syncope.

 – Patient follows medication regimen.

Patient is scheduled for surgical tumor removal (adrenalectomy). Patient expresses fear and uncertainty about the procedure.

Deficient Knowledge related to unfamiliarity with pheochromocytoma and its management as evidenced by patient’s questions and concerns.

– Patient will verbalize understanding of the disease and treatment plan. 

– Patient will express reduced fear and anxiety about surgery.

 – Patient will adhere to preoperative and postoperative care instructions.

1. Explain pheochromocytoma, its effects, and treatment options. 

2. Educate patient on preoperative preparation, including medication use (e.g., alpha-blockers). 

3. Inform the patient about potential postoperative complications. 

4. Provide written educational materials for reinforcement. 

5. Encourage patient to ask questions and express concerns.

1. Increases patient understanding and reduces uncertainty. 

2. Ensures safe surgery by preventing hypertensive crisis. 

3. Helps the patient anticipate and manage postoperative recovery. 

4. Supports learning and recall of important information. 

5. Promotes active patient participation in care.

– Patient demonstrates understanding of condition and treatment.

 – Patient verbalizes reduced fear about surgery.

 – Patient follows preoperative and postoperative instructions.

Patient is unable to engage in normal activities due to fatigue, dizziness, and palpitations.

Activity Intolerance related to catecholamine-induced cardiovascular instability as evidenced by fatigue, dizziness, and exertional dyspnea.

– Patient will gradually resume activities without excessive fatigue.

 – Patient will report improved tolerance to physical exertion.

 – Patient will engage in energy-conserving techniques.

1. Assess activity tolerance and monitor for symptoms of intolerance. 

2. Encourage rest periods between activities. 

3. Teach energy conservation strategies. 

4. Gradually reintroduce physical activity as tolerated. 

5. Monitor blood pressure and heart rate during activity.

1. Prevents overexertion and worsening of symptoms. 

2. Conserves energy and prevents fatigue. 

3. Helps the patient manage limited energy levels. 

4. Improves endurance and quality of life. 

5. Ensures hemodynamic stability during exertion.

– Patient engages in activities with minimal fatigue. 

– Patient reports improved energy levels. 

– Vital signs remain stable during exertion.