Aldosteronism

Aldosteronism is the hyperexretion of alosterone by the adrenal glands.

Etiology and Physiology
Aldosteronism affects men and women equally. It is the cause of HTN in about 2% of patients who have HTN. It is usually caused by an adrenal adenoma (tumor) or overactivity of adrenal tissue called bilateral adrenal hyperplasia. Patients with this condition will have HTN, hypernatremia and hyponatremia.

Signs and Symptoms
HTN, hyponatremia and hypokalemia is the trademark sign of this disorder. Other signs are:
 * Weakness and muscle cramping d/t hypokalemia
 * polydipsia
 * polyuria
 * Cardiac dysrhythmias

Treatment
Surgical removal of the adenoma is preferred. If the cause is hyperplasia then spirolactone is a potassium sparing diuretic used to decrease sodium and water retention while increasing potassium levels. Dexamethasone decreases adrenal hyperplasia. Aminogluethimide (Cytadren) reduces aldosterone synthesis. Calcium channel blockers are used to treat high BP

Nursing Considerations
If surgery is required then correction of sodium and potassium imbalances are needer preop. Low sodium diet and potassium sparing diuretics are preferred. Potassium supplements may be used but not concurrently with potassium sparing diuretics due to the risk of hyperkalemia.

Postop watch for cardiac function, fluid and electrolyte blanaces.

If on replacement therapy educate the patient about side effects such as gynocomastia, menstrul disorders, impotence. Also need to educate about signs of hypokalemia and hypernatremia. Stress need for lifelong replacement therapy and medical supervision.