Endocrine | Hyperaldosteronism for NCLEX

Oh what's up guys nurse Lake here and welcome to simple nursing calm before we start today's video please remember to access your free quiz and preview our new study guides not on YouTube click the link right up here anytime during this video alright let's get to it Pablo is a 32 year old male presenting with a blood pressure of 145 over 95 ST depression on the cardiac monitor serum potassium of 3.1 in complaints of frequent urination during the day oh snap what could be wrong with Pablo and what priority nursing interventions do you need to know for the NCLEX I'm nurse Blake and today we're talking about hyperaldosteronism which is what happens when there is too much secretion of aldosterone aka aldosterone he is our security guard bouncer of the kidneys we'll call him al for short he add sodium and water into the body by not letting it leave the kidneys which makes the blood pressure go crazy high in l4 let's potassium out of the body and into the body which causes low potassium aka hypokalemia in fancier medical terms hyperaldosteronism also aldosterone ism is a medical condition where the adrenal cortex secretes too much aldosterone hormone which can lead to lower levels of potassium in the blood hypokalemia an increased hydrogen ion excretion alkalosis now we also call out our salt water hormone to help students differentiate between aldosterone and ADH the antidiuretic hormone a totally different hormone that keeps water in the body and not in the potty okay so let's do a quick review of normal adrenal physiology as you know the adrenals sit on top of the kidneys and help the body adapt to stress by using Mac hormones just like Mac computers the adrenals look like the Apple logo so remember the acronym Mac M since for mineral corticoids like aldosterone aka aldosterone are steroid hormone security guard bouncer to the kidneys in the rena angiotensin aldosterone system again remember al he add sodium and water in to balance blood pressure in L let's potassium out of the body and into the potty next is a for androgen steroids to help with hair in sex and our first c is for cortisol steroid our very famous stress hormone lastly C is their catecholamines epi in nor epi also called adrenaline our fight and flight hormones which increase heart rate and blood pressure okay so now that we reviewed the basics of normal physiology what's going on in hyper al well we have high aldosterone right so the ability to add sodium and water into the body is super high which leads to hypernatremia and hypertension and the loss of potassium is greater so hypokalemia sets in and we get a higher ph level as the body loses more hydrogen ions in the urine this is called metabolic alkalosis so we will see complaints that all stem from high ow high aldosterone again our main sign and symptom think high la4 add sodium in water so we get hypernatremia over 145 and hypertension a blood pressure of over 140 over 90 L is for loss of potassium resulting in hypokalemia a potassium level of 3.5 or less now our main sign for hypernatremia is polydipsia extreme thirst a swollen dry tongue and increased muscle tone which is a huge inc lex tip in our big symptoms for hypertension are headaches and facial redness also called flushing now for hypokalemia our low potassium of 3.5 or less everything will be low and slow so our heart monitor will show ST depression and prominent new waves so remember anyone with low potassium we always put them on a heart monitor this is the first thing we do as a nurse I can't stress that enough it's always a big priority as far as a muscular system it will be low and slow with decreased DTRS deep tendon reflexes and lastly GI will be low and slow with constipation and hypoactive bowel sounds okay now for the weird signs and symptoms patients get both polyuria which is frequent urination and diluted urine which is a low specific gravity of less than one point zero zero five so to help you remember this for your next test or the NCLEX use the acronym hyper al h for hypertension a blood pressure of over 140 over 90 and why is for yielding or slow DTRS and bowel sounds P is for polyuria and polydipsia excessive urination and thirst e is her ECG and this will show you waves an ST depression from the low potassium of less than 3.5 and again the first action is to always put this patient on a cardiac monitor the patient's heart can stop with low potassium so do this first r is for raining urine a low SG of 1.00 5a is for adding sodium a sodium level of over 145 and L is for losing potassium 3.5 or less okay so now what are the causes well it can occur because of primary causes like those inside the adrenals or from secondary causes outside the adrenals okay let's start with the primary causes now it's usually idiopathic which means we don't know why it's caused idiopathic means we're idiots to the pathology but a big cause is usually from Kahn syndrome where a non-cancerous tumor grows inside one of the adrenals this makes the adrenal over produced hormones so we see that little white dot right there this is our little tumor lastly family genetics can play a role meaning it runs in the family this can cause high blood pressure in children and teens now switching over to secondary it's caused by things outside the adrenals this happens in congestive heart failure where the renals receive less blood flow due to less cardiac output from the heart this low oxygen to the kidneys forces our kidneys to think the body has a low blood pressure so the kidneys react by releasing the Dominos into activation of the wrasse system the renin-angiotensin-aldosterone system this keeps water and blood pressure up but we are left with too much of dosterone our last common cause is from the renal artery stenosis this is where the narrowing of the kidney tubes results in less blood flow to the kidneys and again the kidneys think the body has a low blood pressure so again more renin gets produced and the cycle of Wrath starts all over again so now our labs help to pinpoint the cause so in primary we'll see low renin and high aldosterone like in Kahn syndrome when a tumor of one adrenal is secreting the high aldosterone so the body turns off renin but we still have high ow and in secondary we see both high renin and high aldosterone like in heart failure or Reynosa gnosis the body thinks there is a low blood pressure so high Renan production turns on the wrath system which produces both high renin and high aldosterone so now that we know what is wrong with our patient what are we gonna do about it what's the main goal we need to lower that aldosterone so we can lower that fluid volume and raise that potassium this is our priority since fluid volume overload can impair airway and breathing so we give potassium sparing diuretic in these guys in an act own like spironolactone remember that diuretics make the body diurese fluid meaning making you pee and usually we lose potassium during urination because we're fluids flow electrolytes go and you know where fluid flows electrolytes go well not in this case spur ona lactone is a potassium sparing diuretic which helps keep potassium in the body and not in the potty so we call spironolactone a special hitman that targets and deactivates aldosterone directly lastly if all else fails we could do an adrenalectomy this surgery just cuts off the adrenal glands which is causing the problem pretty simple right wrong cutting off an adrenal can cause an Addison's crisis where we have nomack hormones to keep the blood pressure up this means no blood pressure stability it can lead to hypotensive shock meaning blood pressure so low that it can actually kill the patient now we go over all the treatments for this crisis in our Addison's video but just for the test please know that we're moving a kidney or an adrenal can cause this crisis and kill your patient alright guys that wraps it up thanks so much for watching thanks for watching for our 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Channel: Simple Nursing

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Keywords: registered nurse RN, osmosis, Aldosteronism, Aldosterone, High aldosterone, Hormone dysfunction, Hormone diseases, Aldosterone diseases, Adrenal gland diseases, Conn’s syndrome, Hyperaldosteronism, aldosterone, hyperactive adrenal glands, hormones, aldosteronism, endocrine, Registered nurse RN, RN, Osmosis, Pharmacology, NCLEX, ATI exit, HESI exit, Kaplan, student nurse, nursing student, simplenursing

Id: kgawuPx3Brs

Length: 9min 38sec (578 seconds)

Published: Wed Jan 16 2019