Question

The nurse collects a 24-hour urine specimen for catecholamine testing from a client with suspected pheochromocytoma. The results of the catecholamine test are reported as epinephrine 20 mcg (109 nmol) and norepinephrine 100 mcg (590 nmol). The nurse should make which interpretation about this result?

a) Normal catecholamine levels
b) Increased epinephrine, normal norepinephrine
c) Decreased epinephrine, increased norepinephrine
d) Elevated levels of both epinephrine and norepinephrine

Answer 1

The nurse should interpret the results as elevated levels of both epinephrine and norepinephrine, suggesting a potential pheochromocytoma as these levels exceed normal 24-hour urinary ranges. Elevated catecholamines can indicate excessive hormonal release possibly due to a pheochromocytoma.

Step-by-step explanation:

The nurse should interpret the results of the epinephrine and norepinephrine levels as elevated levels of both epinephrine and norepinephrine. Pheochromocytoma is a condition characterized by excessive production of catecholamines by the adrenal glands, which include epinephrine (adrenaline) and norepinephrine (noradrenaline). Normally, these hormones are part of the body's fight or flight response, produced in times of stress and acting to temporarily increase heart rate, blood pressure, and energy supplies by constriction of blood vessels and redirection of blood flow to essential organs.

The reference range for normal urinary epinephrine is approximately 0.5 to 20 micrograms in a 24-hour period, and for norepinephrine is 15 to 80 micrograms. In this case, with epinephrine levels at 20 mcg and norepinephrine at 100 mcg over a 24-hour period, the patient's levels are considered elevated, indicating a likeliness of pheochromocytoma or another cause for the excessive hormone release. This excess can lead to symptoms like hypertension, headaches, palpitations, and could potentially lead to more serious conditions such as arrhythmias if left untreated.