aldosteronism /al′dōstərō″nizəm, aldos″-/ , a condition characterized by the hypersecretion of aldosterone, occurring as a primary disease of the adrenal cortex or, more often, as a secondary disorder in response to various extraadrenal pathological processes. Primary aldosteronism, may be caused by adrenal hyperplasia or by an aldosterone-secreting adenoma. Secondary aldosteronism is associated with increased plasma renin activity and may be induced by nephrotic syndrome, cirrhosis, idiopathic edema, congestive heart failure, trauma, burns, or other kinds of stress. Also called Conn’s syndrome, hyperaldosteronism. ▪ OBSERVATIONS: In many cases the only manifestation of Conn’s syndrome is mild to moderate hypertension. Other signs and symptoms include episodic weakness, fatigue, paresthesia, polyuria, polydipsia, and nocturia. Glycosuria, hyperglycemia, and personality disturbances are occasionally manifested. Laboratory tests may show decreased plasma renin activity (measured after restricted sodium and/or diuretic therapy), increased aldosterone levels (measured after sodium loading), normal blood chemistry values, or hypernatremia and hypokalemia. A CT scan may be used to detect the presence of an adenoma. ▪ INTERVENTIONS: Treatment includes regular monitoring and control of blood pressure and hypokalemia with spironolactone, amiloride hydrochloride, or angiotensin-converting enzyme inhibitors. A low-sodium diet, cessation of tobacco use, weight reduction (if indicated), and regular exercise are also advised. A unilateral adrenalectomy is performed if an adenoma or a carcinoma is present, and chemotherapy with mitotane may be an option. ▪ PATIENT CARE CONSIDERATIONS: Nurses should focus on blood pressure monitoring and education. Instruction is needed in the use and expected side effects of medications, including gynecomastia, menstrual irregularities, and reduced libido with spironolactone. Dietary management (low sodium) should be addressed and a regular exercise regimen established and monitored. Counseling or referrals should be made for those who use tobacco products. The patient and a family member should be taught to monitor blood pressure on a regular basis. The importance of medical follow-up should be emphasized.
