Final Exam- Endocrine Problems part 2 (Unit 12): Disorders of the Parathyroid Gland

Question 1

What mineral should you think of when you hear the Parathyroid gland ?

Answer 1

CALCIUM & phosphorus

Question 2

Where are the parathyroid glands located in the body ?

Answer 2

Sit on top of the Thyroid gland

Question 3

Calcium and Phosphorus have what type of relationship in the body ?

Answer 3

INVERSE Relationships

Question 4

The Parathyroid helps regulate what ?

Answer 4

• Serum Calcium Levels* by……
• stimulating the release of calcium from the bones
• renal tubular reabsorption of calcium
• activation of Vitamin D

Question 5

PTH stands for what ?

Answer 5

Parathyroid Hormone

Question 6

Increased secretion of Parathyroid Hormone (PTH) does what in the body ?

Answer 6

• Increases serum calcium

- Decreases serum phosphate levels

Question 7

What causes Hyperparathyroidism ?

Answer 7

• Neoplasms/adenomas
• Vitamin deficiency
• Renal failure

Question 8

What are Clinical Manifestations of Hyperparathyroidism ?

Answer 8

• Osteoporosis, fractures
• Kidney stones (nephrolithiasis)
• Neuromuscular abnormalities (muscle weakness, shortened attention span)
• Loss of appetite
• Constipation
• Fatigue

Question 9

How is Hyperparathyroidism detected ?

Answer 9

• Elevated PTH levels
• Elevated serum calcium (> 10mg/dL)
• Low serum phosphate (< 3.0mg/dL)
• Elevated urine calcium
• Bone density tests, may detect bone loss

Question 10

What is the Tx of choice for Hyperparathyroidism ?

Answer 10

Surgery to remove the parathyroid glands

Question 11

What are some Non-surgical Tx options for Hyperparathyroidism ?

Answer 11

• serial x-rays to assess for bone loss
• ambulation to strengthen bones
• high fluid intake
• moderate calcium intake (may need to work w/ dietician)

Question 12

What are 2 examples of how drugs are used in the Tx of Hyperparathyroidism ?

Answer 12

• Lower calcium levels in the blood, by pushing calcium into bones. (but do not treat underlying issue). EX: Fosamax
• Decrease PTH secretion of calcium

Question 13

What is a Parathyroidectomy ?

Answer 13

Parathyroid removal

Question 14

What are the 2 Major post-op complications of a parathyroidectomy ?

Answer 14

• Hemorrhage

- Electrolyte disturbances (ENCOURAGE Fluids !!)

Question 15

What should you monitor for in patients who just had a Parathyroidectomy ?

Answer 15

Tetany

Question 16

What is Tetany caused by ?

Answer 16

Hypocalcemia

Question 17

What is Tetany ?

Answer 17

Neuromuscular hyperexcitability

Ex: hand/feet spasms

• cramps
• spasms of the voice box (larynx)

Question 18

What is Mild Tetany present as ?

Answer 18

Unpleasant tingling of the hands and around the mouth

Question 19

Sever Tetany (from Severe hypocalcemia) will present as what ?

Answer 19

• Muscle spasms

- Laryngospasms

Question 20

What nursing interventions does Severe tetany require?

Answer 20

• IV calcium gluconate
  OR
• IV calcium chloride

Question 21

What is Hypoparathyroidism defined by ?

Answer 21

Inadequate circulating PTH

Question 22

What is Hypoparathyroidism characterized by ?

Answer 22

Lack of circulating calcium

Question 23

With Hypoparathyroidism, how do you need to treat emergent tetany ?

Answer 23

Calcium glucanate OR calcium chloride

Question 24

When administering calcium glucanate OR calcium chloride for tetany, at what rate should it be given ? And what should you place the pt on ?

Answer 24

1. Give slowly

2. Continuous EKG monitoring

Question 25

Why do we want to place pt’s on continuous EKG monitoring when administering calcium glucanate or calcium chloride ?

Answer 25

B/c, high serum calcium levels can cause

• hypotension
• cardiac dysrhythmias
• cardiac arrest

Question 26

______________ can alleviate acute neuromuscular symptoms associated with hypocalcemia ?

Answer 26

Rebreathing

Question 27

Pt’s with chronic Hypoparathyroidism require what type of Tx ?

Answer 27

Need lifelong daily oral calcium supplements and vitamin D

Question 28

Pt’s with Hypoparathyroidism should eat what type of foods ?

Answer 28

• High calcium foods

- Ex: dark green vegetables, soybeans, tofu

Question 29

Pt’s with Hypoparathyroidism should avoid what kinds of foods ?

Answer 29

• Spinach
• Rhubarb
• Bran & Whole grains
• Dairy products