A client returns from the operating room after adrenalectomy. Which assessment is most concerning?

A client returns from the operating room after adrenalectomy. Which assessment is most concerning?

• A. Glucose of 70 mg/dL
• B. Potassium of 3.4 mEq/L
• C. Blood Pressure of 169/98 mm Hg
• D. Sodium of 146 mEq/L

Answer: (C)

Postoperative hypertension is the most concerning finding after adrenalectomy, especially if a pheochromocytoma was involved. The adrenal medulla tumor secretes catecholamines that drive very high blood pressure. After removing the gland, if there’s any remaining catecholamine effect or if the patient experiences a catecholamine surge during surgery, persistently elevated blood pressure can signal ongoing or rebound catecholamine influence. This puts the patient at immediate risk for myocardial ischemia, heart failure, stroke, or other recovery complications, so it demands prompt assessment and management with antihypertensives and careful hemodynamic monitoring. In contrast, cortisol deficiency from loss of adrenal tissue tends to cause hypotension and hypoglycemia, not hypertension, and aldosterone deficiency would lead to volume depletion with hyperkalemia and hyponatremia—not a high blood pressure. The other listed values are less acutely alarming in this context.

Postoperative hypertension is the most concerning finding after adrenalectomy, especially if a pheochromocytoma was involved. The adrenal medulla tumor secretes catecholamines that drive very high blood pressure. After removing the gland, if there’s any remaining catecholamine effect or if the patient experiences a catecholamine surge during surgery, persistently elevated blood pressure can signal ongoing or rebound catecholamine influence. This puts the patient at immediate risk for myocardial ischemia, heart failure, stroke, or other recovery complications, so it demands prompt assessment and management with antihypertensives and careful hemodynamic monitoring.

In contrast, cortisol deficiency from loss of adrenal tissue tends to cause hypotension and hypoglycemia, not hypertension, and aldosterone deficiency would lead to volume depletion with hyperkalemia and hyponatremia—not a high blood pressure. The other listed values are less acutely alarming in this context.