Final Exam- Endocrine Problems part 2 (Unit 12): Disorders of the Parathyroid Gland Flashcards
What mineral should you think of when you hear the Parathyroid gland ?
CALCIUM & phosphorus
Where are the parathyroid glands located in the body ?
Sit on top of the Thyroid gland
Calcium and Phosphorus have what type of relationship in the body ?
INVERSE Relationships
The Parathyroid helps regulate what ?
- Serum Calcium Levels* by……
- stimulating the release of calcium from the bones
- renal tubular reabsorption of calcium
- activation of Vitamin D
PTH stands for what ?
Parathyroid Hormone
Increased secretion of Parathyroid Hormone (PTH) does what in the body ?
- Increases serum calcium
- Decreases serum phosphate levels
What causes Hyperparathyroidism ?
- Neoplasms/adenomas
- Vitamin deficiency
- Renal failure
What are Clinical Manifestations of Hyperparathyroidism ?
- Osteoporosis, fractures
- Kidney stones (nephrolithiasis)
- Neuromuscular abnormalities (muscle weakness, shortened attention span)
- Loss of appetite
- Constipation
- Fatigue
How is Hyperparathyroidism detected ?
- Elevated PTH levels
- Elevated serum calcium (> 10mg/dL)
- Low serum phosphate (< 3.0mg/dL)
- Elevated urine calcium
- Bone density tests, may detect bone loss
What is the Tx of choice for Hyperparathyroidism ?
Surgery to remove the parathyroid glands
What are some Non-surgical Tx options for Hyperparathyroidism ?
- serial x-rays to assess for bone loss
- ambulation to strengthen bones
- high fluid intake
- moderate calcium intake (may need to work w/ dietician)
What are 2 examples of how drugs are used in the Tx of Hyperparathyroidism ?
- Lower calcium levels in the blood, by pushing calcium into bones. (but do not treat underlying issue). EX: Fosamax
- Decrease PTH secretion of calcium
What is a Parathyroidectomy ?
Parathyroid removal
What are the 2 Major post-op complications of a parathyroidectomy ?
- Hemorrhage
- Electrolyte disturbances (ENCOURAGE Fluids !!)
What should you monitor for in patients who just had a Parathyroidectomy ?
Tetany
What is Tetany caused by ?
Hypocalcemia
What is Tetany ?
Neuromuscular hyperexcitability
Ex: hand/feet spasms
- cramps
- spasms of the voice box (larynx)
What is Mild Tetany present as ?
Unpleasant tingling of the hands and around the mouth
Sever Tetany (from Severe hypocalcemia) will present as what ?
- Muscle spasms
- Laryngospasms
What nursing interventions does Severe tetany require?
- IV calcium gluconate
OR - IV calcium chloride
What is Hypoparathyroidism defined by ?
Inadequate circulating PTH
What is Hypoparathyroidism characterized by ?
Lack of circulating calcium
With Hypoparathyroidism, how do you need to treat emergent tetany ?
Calcium glucanate OR calcium chloride
When administering calcium glucanate OR calcium chloride for tetany, at what rate should it be given ? And what should you place the pt on ?
- Give slowly
2. Continuous EKG monitoring
Why do we want to place pt’s on continuous EKG monitoring when administering calcium glucanate or calcium chloride ?
B/c, high serum calcium levels can cause
- hypotension
- cardiac dysrhythmias
- cardiac arrest
______________ can alleviate acute neuromuscular symptoms associated with hypocalcemia ?
Rebreathing
Pt’s with chronic Hypoparathyroidism require what type of Tx ?
Need lifelong daily oral calcium supplements and vitamin D
Pt’s with Hypoparathyroidism should eat what type of foods ?
- High calcium foods
- Ex: dark green vegetables, soybeans, tofu
Pt’s with Hypoparathyroidism should avoid what kinds of foods ?
- Spinach
- Rhubarb
- Bran & Whole grains
- Dairy products
