A pheochromocytoma or phaeochromocytoma (PCC) is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth and secretes excessive amounts of catecholamines, usually noradrenaline (norepinephrine), and adrenaline (epinephrine) to a lesser extent. Extra-adrenal paragangliomas (often described as extra-adrenal pheochromocytomas) are closely related, though less common, tumors that originate in the ganglia of the sympathetic nervous system and are named based upon the primary anatomical site of origin.
Nursing Management of Pheochromocytoma
- Monitor vital signs, especially blood pressure changes--> severe hypertension can precipitate a cerebrovascular accident and/or sudden blindness
- Administer antihypertensive medications as ordered
- Promote rest and decrease stressful stimuli--> acute attacks may be precipitated by emotional stress, physical exertion, and change in position
- Monitor urine tests for glucose and acetone--> clients with pheochromocytoma may present with manifestations of diabetes mellitus
- For clients on 24-hour VMA testing--> instruct to avoid vigorous and prolonged exercise and intake of coffee, tea, chocolate, bananas, and vanilla-flavored food at least two days prior to and during urine collection (note: clincians may also order client to stop taking medications like methyldopa, L-Dopa, paracetamol at least three days prior to urine collection as well)
- Provide high-calorie, well-balanced diet
- Instruct patient to avoid smokinga nd stimulants like coffee and tea--> may influence catecholamine release
- For clients with an adrenalectomy, observe for BP changes-- clients are at risk for shock due to a drastic drop in catecholamine levels
- Provide client teaching on possibility of lifeslong steroid replacement (for bilateral adrenalectomy)