Fluid and Electrolytes: Hyper/Hypoparathyroidism Flashcards
What does the parathyroid gland secrete?
Parathyroid hormone
What triggers the secretion of the parathyroid hormone?
Calcium levels
What do PTH and Calcitonin do?
They work together to maintain the balance of calcium in the blood
How does PTH control calcium and phosphorus?
Increases calcium absorption by the kidneys; decreases phosphorus through excretion
PTH regulates calcium and phosphorus metabolism by acting on bones, the kidneys, and the GI tract
What are the risks if the parathyroid glands are injured or removed?
The patient may develop hypocalcemia
What are the causes of hyperparathyroidism?
- parathyroid tumor or cancer
- Congenital hyperplasia
- Neck trauma or radiation
- Vitamin D deficiency
- Chronic kidney disease with hypocalcemia
- Parathyroid hormone-secreting carcinomas of the lung, kidney or GI tract
What are the causes of hypothyroidism
- Surgical or radiation-induces thyroid ablation
- parathyroidectomy
- Congenital dysgenesis
- Idiopathic (autoimmune) hypoparathyroidism
- Hypomagnesemia
What is hyperparathyroidism?
- results from an increase in the secretion of parathyroid hormone, which regulates normal serum levels of calcium
- affects the kidneys and bones resulting in an increased resorption of calcium
- increased the risk of hypercalcemia and hypophosphatemia
What populations are more at risk of Hyperparathyroidism?
- older adults
2. More often in women
What are the cardiovascular symptoms of hyperparathyroidism?
- dysrhythmias
- hypertension
- Increased sensitivity to cardiotonic glycosides (digitalis preparations)
What are the musculoskeletal symptoms of hyperparathyroidism?
Muscle weakness and atrophy
What are the renal symptoms of hyperparathyroidism?
- metabolic acidosis
- Renal calculi formation
- Polyruia
What are the GI symptoms of hyperparathyroidism?
- Abdominal pain
- Constipation
- Anorexia
- Peptic ulcer formation
What are some treatments for mild hypercalcemia due to hyperparathyroidism?
- drink fluids and keep active
- avoid immobilization, thiazide diuretics, large doses of Vitamins A and D, antacids containing calcium, and calcium supplements
What are some treatments for severe hypercalcemia due to hyperparathyroidism?
- requires hospitalization
- Intensive treatment with IV saline
- Medications to inhibit bone resorption and reduce hypercalcemia
Why may surgery be needed for hyperparathyroidism?
The parathyroid glands affected by hyperplasia or adenoma may need to be removed
What is hypoparathyroidism?
- results from abnormally low PTH level
- Most common case is damage to or inadvertent removal of all the parathyroid glands during thyroidectomy
- Lack of PTH causes hypocalcemia and an elevated blood phosphate level
What are the musculoskeletal manifestations of hypoparathyroidism?
- muscle spasms
- facial grimacing
- carpopedal spasms
- Tetany or convulsions
What are the integumentary manifestations of hypoparathyroidism?
- brittle nails
- Hair loss
- dry scaly skin
What are the GI manifestations of Hypoparathyroidism?
abdominal cramps and malabsorption
What is a cardiovascular manifestation of hypoparathyroidism?
Dysrhythmias
What are the CNS manifestations of Hypoparathyroidism?
- paresthesia (lips, hands, and feet)
- Mood disorders (irritability, depression, anxiety)
- Hyperactive reflexes
- Psychosis
- Increased intracranial pressure
What are the treatments for hypoparathyroidism?
- intravenous calcium gluconate is given immediately to reduce tetany
- Long term therapy includes supplemental calcium, increased dietary calcium, and vitamin D therapy
