A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most closely monitor which item in the preoperative period?

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Multiple Choice

A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most closely monitor which item in the preoperative period?

Explanation:
The main concept is that pheochromocytoma causes unpredictable surges of catecholamines, leading to dangerous swings in blood pressure and heart rate. Because the tumor can release large amounts of epinephrine and norepinephrine, the patient’s hemodynamic status can change rapidly during the preoperative period, anesthesia induction, and tumor handling. Monitoring vital signs provides real-time information on the patient’s blood pressure and heart rate, allowing immediate detection of hypertensive crises or tachyarrhythmias and timely intervention (adjusting alpha- blockade, delaying surgery, or preparing vasodilators). This focus on vital signs is why they’re the most important parameter to watch preoperatively. While intake/output, BUN, and urine glucose/ketones give useful information about fluid balance, renal function, or metabolic status, they do not reflect the imminent cardiovascular instability that catecholamine surges can provoke.

The main concept is that pheochromocytoma causes unpredictable surges of catecholamines, leading to dangerous swings in blood pressure and heart rate. Because the tumor can release large amounts of epinephrine and norepinephrine, the patient’s hemodynamic status can change rapidly during the preoperative period, anesthesia induction, and tumor handling. Monitoring vital signs provides real-time information on the patient’s blood pressure and heart rate, allowing immediate detection of hypertensive crises or tachyarrhythmias and timely intervention (adjusting alpha- blockade, delaying surgery, or preparing vasodilators).

This focus on vital signs is why they’re the most important parameter to watch preoperatively. While intake/output, BUN, and urine glucose/ketones give useful information about fluid balance, renal function, or metabolic status, they do not reflect the imminent cardiovascular instability that catecholamine surges can provoke.

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