👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: adrenal tumor · catecholamine tumor · pheo · epinephrine tumor · blood pressure tumor
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Use this quick-reference guide to spot, treat, and prevent Pheochromocytoma on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Mechanism
Adrenal medulla tumor
↑ epi/norepi → severe HTN
🩺 Signs
5 H's: HTN, headache, hyperhidrosis
Palpitations, paroxysmal BP spikes
Tremor, pallor, anxiety
🧪 Labs
↑ urine metanephrines/VMA
24-hr urine catecholamines
✅ Do
Alpha-block FIRST, then beta
Adrenalectomy = definitive tx
No palpate abdomen → BP crisis
📚 Pheochromocytoma — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Pheochromocytoma is a usually benign tumor of the adrenal medulla that secretes excess catecholamines (epinephrine and norepinephrine), causing episodes of severe hypertension. The hormone surges produce dramatic, paroxysmal symptoms and dangerous blood pressure spikes. Memory aid: the classic triad is the '5 Ps' simplified to pounding headache, palpitations, and perspiration (diaphoresis) with severe hypertension. Definitive treatment is surgical removal of the tumor.
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Key points
Understand these first
Hallmark finding is severe, often paroxysmal hypertension, sometimes with markedly elevated blood pressure.
Classic triad is pounding headache, palpitations/tachycardia, and profuse diaphoresis.
Other features include anxiety, tremor, flushing, pallor, and hyperglycemia.
Catecholamine surges can be triggered by stress, exertion, or palpation of the abdomen.
Diagnosis is supported by elevated urine and plasma catecholamines and metanephrines (24-hour urine for VMA/metanephrines).
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Nursing priorities
What to do, in order
Monitor blood pressure frequently and avoid palpating the abdomen, which can trigger a catecholamine surge.
Provide a calm, restful environment and minimize stress and stimulation.
Administer alpha-adrenergic blockers first as ordered, then beta blockers, to control blood pressure preoperatively.
Prepare the patient for adrenalectomy and monitor for hemodynamic instability before, during, and after surgery.
Monitor blood glucose and provide adequate hydration.
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Red flags — report now
Escalate immediately
A hypertensive crisis with severe headache, chest pain, or neurologic changes is a life-threatening emergency.
Never palpate the abdomen, as it can trigger a sudden, dangerous catecholamine release.
Report severe blood pressure swings or signs of stroke or myocardial infarction immediately.
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Labs & values
Numbers to know
24-hour urine metanephrines/VMA: elevated
Plasma free metanephrines: elevated
Glucose: may be elevated (normal fasting 70-100 mg/dL)
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Patient teaching
What patients must know
Avoid activities and foods that trigger episodes, and report severe headache, sweating, or palpitations.
Take prescribed blood pressure medications exactly as directed before surgery.
After adrenalectomy, attend follow-up to monitor blood pressure and hormone levels.
❓ Pheochromocytoma: NCLEX FAQs
What are the priority nursing interventions for Pheochromocytoma?
Monitor blood pressure frequently and avoid palpating the abdomen, which can trigger a catecholamine surge. Provide a calm, restful environment and minimize stress and stimulation. Administer alpha-adrenergic blockers first as ordered, then beta blockers, to control blood pressure preoperatively. Prepare the patient for adrenalectomy and monitor for hemodynamic instability before, during, and after surgery.
What are the warning signs of Pheochromocytoma a nurse must report?
A hypertensive crisis with severe headache, chest pain, or neurologic changes is a life-threatening emergency. Never palpate the abdomen, as it can trigger a sudden, dangerous catecholamine release. Report severe blood pressure swings or signs of stroke or myocardial infarction immediately.
What do I need to know about Pheochromocytoma for the NCLEX?
Hallmark finding is severe, often paroxysmal hypertension, sometimes with markedly elevated blood pressure. Classic triad is pounding headache, palpitations/tachycardia, and profuse diaphoresis. Other features include anxiety, tremor, flushing, pallor, and hyperglycemia. Catecholamine surges can be triggered by stress, exertion, or palpation of the abdomen.
What patient teaching is important for Pheochromocytoma?
Avoid activities and foods that trigger episodes, and report severe headache, sweating, or palpitations. Take prescribed blood pressure medications exactly as directed before surgery. After adrenalectomy, attend follow-up to monitor blood pressure and hormone levels.
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Quick Tip
Hallmark finding is severe, often paroxysmal hypertension, sometimes with markedly elevated blood pressure.