VISION A premier university in historic Cavite recognized for excellence in the development of morally upright and globally competitive

individuals.

Republic of the Philippines CAVITE STATE UNIVERSITY Don Severino Delas Alas Campus Indang, Cavite

College of Nursing
Dumagat, Vernadeth B. PRIMARY ALDOSTERONISM Identification

MISSION Cavite State University shall provide excellent, equitable and relevant educational opportunities in the arts, science and technology through quality instruction and relevant research and development activities. It shall produce professional, skilled and morally upright individuals for global competitiveness.

BSN 3-1

1. A steroid hormone located at adrenal cortex which regulates salt and water balance in the body. 2. Overproduction of minerolocorticoid hormone which regulates sodium in the kidney. 3. Part of the adrenal gland where the hormone aldosterone located. 4. Surgical removal of the adrenal tumor. 5. Inability of the part of the kidney to acidify or concentrate the urine wherein the urine volume is excessive. 6. An adrenal cortex steroid drug used to maintain blood pressure in clients with primary aldosteronism. 7. A benign tumor of the adrenal gland. 8. Most prominent and universal sign of patient with primary aldosteronism. 9. Decline in serum levels of potassium. 10. A decrease in ionized serum calcium level. 11. Part of nephrons leads away from the glumerolus. 12. Small but richly artery located at the neck. 13. A type of adrenalectomy which replacement of corticosteroid may be lifelong. 14. A condition wherein serum is concentrated or increased or an increased in thirst. 15. An abnormality that indirectly results in pathology through a predictable physiologic pathway, a renin producing tumor leads to increased aldosterone, as the body's aldosterone production is normally regulated by renin levels.

Multiple Choice 16. Muscle weakness, cramping and fatigue are signs and symptoms of what particular clinical manifestations in client with primary aldosteronism? a. Hyperkalemia c. Hypokalemia b. Hypothyrodism d. Hyponatremia 17. In client with primary aldosteronism, it is used to assess neuromuscular irritability before tetany and paresthesia occur. a. Serum Free T4 Test c. Sensory Reflex Test b. Trousseaus and Chvosteks d. Neurologic Vital Signs Test 18. In client taking spironolactone, which of the following nursing responsibility should be in need of supervision? a. Taking the drug early because of frequent urination. b. Weighing on monthly basis and record it. c. Avoid foods rich in potassium. d. None of the above. 19. What was the primary action of spironolactone? a. Blocks the effects of aldosterone in the renal tubule. b. Stimulates the adrenal cortex to synthesize and secrete adrenocortical hormones. c. Responsible for anti-inflammatory, immunosuppressive (glucocorticoid), and salt-retaining (mineralocorticoid) actions. d. None of the above. 20. Post-operative nursing management of client undergone adrenalectomy are shown below except. a. Provide comfort measures. b. Watch out for Tachycardia and Hypotension. c. Provide rest periods. d. Take V/S to detect early signs and symptoms of adrenal insufficiency and hemorrhage. 21. What are the indications of Alkalosis in client with primary aldosteronism? a. Decrease in cardiac output and increase in systemic vascular resistance. b. Increase in pH and decrease in partial carbon dioxide. c. Increase in pH and increase in serum bicarbonate concentration. d. All of the above. 22. What is the useful diagnostic test for primary aldosteronism? a. Fasting Blood Sugar c. Deoxycorticosterone Acetate b. Bilateral Adrenal-Venous (DOCA) test Sampling d. Renin-Aldosterone Test

23. Clinical manifestation of primary aldosteronism in relation to insulin production. a. Glucose Intolerance c. Polydypsia b. Hyperglycemia d. Glycosuria 24. What type of adrenalectomy involves suppression of normal adrenal by high levels of adrenal hormones? a. Bilateral Adrenalectomy c. Open Adrenalectomy d. Laparoscopic b. One Adrenal Right Adrenalectomy 25. What was the primary action of Renin? a. Decrease the secretion of enzyme by the juxtaglumelurar cells of the kidney. b. Hydrolyzes angiotensinogen to angiotensin I. c. Both a and b. d. Neither a and b. 26. One side effect of spironolactone is increase thirst, what is an immediate nursing intervention given below? a. Give plenty of water. c. Instruct to eat citrus fruits. b. Suck on sugarless food. d. None of the above. 27. Clinical Manifestations of client with primary aldosteronism are high or normal serum sodium level and a low serum potassium level. What were its diagnostic studies indicates? a. Low serum aldosterone and high serum renin levels. b. Low serum aldosterone and low serum renin levels. c. High serum aldosterone and low serum renin levels. d. High serum aldosterone and high serum renin levels. 28. Coricosteroid are used extensively for adrenal insufficiency. Their antiinflammatory and anti-allergy actions make corticosteroids effective in treating rheumatic or connective tissue diseases such as: a. Multiple Sclerosis and Osteoporosis b. Systemic Lupus Erythematosus and Rheumatoid Arthritis c. Gouty Arthritis and Osteoarthritis d. Carpal Tunnel Syndrome and Osteomyelitis 29. What causes primary aldosteronism to categorize its universal sign to be arterial hypertension? a. It occurs during visits to the doctor but may have normal blood pressure at home. b. It affects the part of the circulatory system that connects the heart and lungs interfering with the lungs ability to transfer oxygen and the heart ability to pump blood. c. The condition affects blood flow to organs such as the kidneys, placenta, brain, and liver.

d. It affects the nerve receptors, carotid sinus which greatly contributes to regulate heart rate and blood pressure. 30. In what type of adrenal hormone does aldosterone belong? a. Glucocorticoid Hormones c. Adrenal Sex Hormones b. Mineralocorticoid Hormones d. None of the above

ANSWERS: Identification Part: 1. 2. 3. 4. 5. 6. 7. 8. Aldosterone Primary Aldosteronism Adrenal Cortex Adrenalectomy Polyuria Corticosteroid Adrenal Adenoma Hypertension 9. Hypokalemia 10. Hypocalcemia 11. Renal Tubule 12. Carotid Sinus 13. Bilateral Adrenalectomy 14. Polydipsia 15. Secondary Aldosteronism

Multiple Choice Part with Rationale: 16. C. Hypokalemia. Skeletal muscle weakness, thread rapid pulse, faint heart sound, decrease BP, lethargy and decrease or absent of reflexes are more profound signs and symptoms of hypokalemia. 17. B. Trousseaus and Chvosteks Test. It is used to assess for hypocalcemia which is a clinical manifestation of client with primary aldosteronism. 18. B. Weighing on monthly basis and record it. One nursing responsibility for client who is taking spironolactone is to instruct the client to weigh on regular basis, same time, same clothing and record the weight on a calendar daily. 19. A. Blocks the effects of aldosterone in the renal tubule. It causes the loss of sodium and water therefore retention of potassium in the kidney. 20. B. Watch out for Tachycardia and Hypotension. This post-op nursing management is mostly seen in patient having metabolic alkalosis. 21. C. Increase in pH and increase in serum bicarbonate concentration. Metabolic Alkalosis can be seen in patient with primary aldosteronism as manifested by increased hydrogen ions secreted in the renal tubule. 22. D. Renin-Aldosterone Test. This is the measurement of aldosterone excretion rate after salt loading. 23. A. Glucose Intolerance. Hypokalemia which is a clinical manifestation in client with primary aldosteronism interferes with insulin secretion from the pancreas.

24. B. One Adrenal. It is temporary because of suppression of normal adrenal by high levels of adrenal hormones. One adrenal gland must be removed in this operation. 25. C. Both a and b. Renin had a big part on diagnostics of primary aldosteronism. 26. B. Suck on sugarless food. It is done together with frequent mouth care to lubricate dry oral mucosa of the patient. 27. C. High serum aldosterone and low serum renin levels. In high serum aldosterone, there is an increase in sodium retention while in low serum renin levels; there is a decrease in secretion of the enzyme by the juxtaglumelurar cells of the kidney. 28. B. Systemic Lupus Erythematosus and Rheumatoid Arthritis. The symptoms from these diseases are caused by the immune system mistakenly attacking the body's own tissues, causing an inflammatory reaction (inflammation). 29. D. It affects the nerve receptors, carotid sinus which greatly contributes to regulate heart rate and blood pressure. Carotid Sinus is an artery located at the neck which mainly affects arterial blood pressure. 30. B. Mineralocorticoid Hormones. Types of steroid hormones which regulates salt and water balance in the body. References: Textbook of Medical-Surgical Nursing 12th Edition Volume 1, Brunner and Suddarth, pp. 1284-1285 2011s Lippincotts Nursing Drug Guide, Amy Karch, pp. 1101-1102 Merriam Websters Medical Dictionary, 2006.