In a patient with adrenal gland hypofunction, which electrolyte abnormality should the nurse monitor for?

In a patient with adrenal gland hypofunction, which electrolyte abnormality should the nurse monitor for?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypercalcemia
• D. Hyponatremia

Answer: (A)

Aldosterone deficiency from adrenal hypofunction disrupts the kidney’s ability to excrete potassium. Aldosterone acts on the distal tubule and collecting duct to increase sodium reabsorption and promote potassium secretion. When aldosterone is lacking, potassium isn’t secreted effectively and accumulates in the blood, leading to hyperkalemia. This is particularly important to monitor because elevated potassium can cause dangerous heart rhythm changes. While hyponatremia and volume depletion can also occur due to reduced sodium reabsorption, the electrolyte abnormality most directly tied to adrenal hypofunction and with immediate cardiac risk is hyperkalemia. Monitor potassium levels closely and watch for signs like muscle weakness or ECG changes.

Aldosterone deficiency from adrenal hypofunction disrupts the kidney’s ability to excrete potassium. Aldosterone acts on the distal tubule and collecting duct to increase sodium reabsorption and promote potassium secretion. When aldosterone is lacking, potassium isn’t secreted effectively and accumulates in the blood, leading to hyperkalemia. This is particularly important to monitor because elevated potassium can cause dangerous heart rhythm changes. While hyponatremia and volume depletion can also occur due to reduced sodium reabsorption, the electrolyte abnormality most directly tied to adrenal hypofunction and with immediate cardiac risk is hyperkalemia. Monitor potassium levels closely and watch for signs like muscle weakness or ECG changes.