CONN’S SYNDROME

A. OVERVIEW
■ Named after Dr. Jerome W. Conn, who first described the condition in 1954
■ Also known as Primary hyperaldosteronism, an endocrine disorder
characterized by excessive secretion of the hormone aldosterone from the adrenal
glands resulting in hypertension, hypokalemia, and alkalosis.
■ CAUSES:
1. Aldosterone-producing adenomas– most common cause
2. Bilateral idiopathic hyperplasia Jerome W. Conn, MD (1907-1994)
Endocrinologist
3. Familial hyperaldosteronism
4. Aldosterone-producing carcinoma – least common cause
B. PREDISPOSING FACTORS

Age Family history Gender

most common in people who are more common in people with a more common in women than
in their 30s and 50s family history of the condition men
or of high blood pressure
 C. ANATOMY AND PHYSIOLOGY
Adrenal glands regulate substance levels in the blood and release “fight-or-flight” hormones

ADRENAL CORTEX ADRENAL

o Mineralocorticoids MEDULLA
= (Aldosterone) Salt o Epinephrine
o Glucocorticoids = o Norepinephrine
(Cortisol) Sugar
o Gonadocorticoids =
(Estrogen &
Androgen) Sex
D. PATHOPHYSIOLOGY
E. LABORATORY STUDY

I. LABORATORY EXAMINATION
■ Aldosterone-to-renin ratio (ARR) test: the recommended screening test in the Endocrine
Society’s 2016 guidelines for detecting primary aldosteronism.
■ Serum electrolyte test
■ Adrenal venous sampling

II. DIAGNOSTIC EXAMINATION

■ Blood pressure measurement
■ CT scan or MRI

Fig.1: CT scan of typical small left adrenal Conn's tumour

F. MEDICAL AND SURGICAL
MANAGEMENT
I. MEDICAL MANAGEMENT
Commonly used medication:
■ Spironolactone (Aldactone)
■ Amiloride is only given when patients are intolerant of spironolactone

II. SURGICAL MANAGEMENT

■ Adrenalectomy: It is the definitive treatment for Conn’s Syndrome.
 G. NURSING CARE PLAN
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N
Subjective Data: Decreased cardiac After 8 hours of Independent 1. To assist in creating an Goal met. After 8
“Nakakaramdam ako 1. Assess the patient’s vital accurate diagnosis and
ng panghihina at hirap
output due to nursing signs and characteristics of monitor effectiveness of hours of nursing
sa paghinga” as hypertension intervention the heart beat atleast every 4
hours.
medical treatment.
2. Stress causes a persistent
intervention the
verbalized by the secondary to patient will be 2. Educate patient on stress increase in cortisol levels, patient was able to
patient. hyperaldosteronis able to maintain management, deep which has been linked to maintain adequate
Method: Interview breathing exercises, and people with hypertension.
m as evidenced by adequate cardiac relaxation techniques. 3. Surgical removal of the cardiac output
Objective Data: high blood output 3. Prepare the patient for
surgery if indicated.
gland with the tumor is
recommended in
* shortness of breath pressure level of hyperaldosteronism.
* high aldosterone
levels
170/90, shortness Dependent
4. Administer prescribed 4. To treat
* fatigue of breath, and medications for hyperaldosteronism caused
* inability to do ADLs high aldosterone hypertension and
hyperaldosteronism
by over activity of both
adrenal glands.
as normal levels 5. Administer supplemental 5. To increase the oxygen
Vital sign as follows: oxygen, as prescribed. level and achieve an SpO2
BP: 170/90 value within the target
T: 37.2 Collaborative range.
PR: 92 bpm 6. Encourage healthier food
RR: 23 bpm options. Refer the patient to 6. Medications and other
SpO2: 92% a dietician as needed. treatments for
hyperaldosteronism are
Method: Physical more effective when
examination and combined with healthy food
Observation choices and lifestyle
modifications.
 H. DRUG STUDY
ADVERSE NURSING
DRUG MECHANISM INDICATIONS CONTRAINDICATI EFFECTS RESPONSIBILITY/
ORDER OF ACTION ONS CONSIDERATION

Brand Name: * Instruct the patient to avoid

It acts on the distal renal
Spironolactone
tubules as a competitive
  antagonist of
aldosterone. It increases
Generic Name:
the excretion of sodium
Aldactone
chloride and water
while conserving
 
potassium and hydrogen
Classification:
ions.
Potassium-
sparing diuretic,
Aldosterone
antagonist
It is indicated to treat * Hypersensitivity * Electrolyte
potassium-containing products.
a number of disturbances Potassium products increase the
* Addison’s disease or other risk of hyperkalemia.
conditions including * Hyperkalemia
conditions associated with
heart failure, * Hyponatremia * Instruct the patient to take it
hyperkalemia
with or without food. Food
hypertension, * Hypovolemia
increases the bioavailability of
hyperaldosteronism, * Anuria * Hypotension spironolactone by nearly 100%. It
should be taken at a consistent
hypokalemia, and * Oliguria
* Acute or progressive renal time in regards to food.
nephrotic syndrome
insufficiency
* Give daily doses early so that
increased urination does not
interfere the patient’s sleep
* Measure and record regular
weight of the patient to monitor
mobilization of edema fluid.
THANK YOU!!!