Hyper/Hypo Parathyroid

Question 1

Hyperparathyroidism

What 2 things could the high levels of calcium cause?
What is calcium opposite of ?

Answer 1

•Increased Parathyroid hormone (PTH) levels are found in the bloodstream, leading to hypercalcemia and hypophosphatemia

1) Leads to decreased bone density (osteoporosis)
2) Causes increased calcium excretion in the urine
- cause formation of renal calculi

Question 2

Hyperparathyroidism signs

Typically associated with hypercalcemia:

Answer 2

• Loss of appetite
• Constipation 💩
• Fatigue😴
• Emotional disorders
• Short attention span
• Muscle weakness

Question 3

Diagnostic LABS for hyperparathyroid

Answer 3

PTH ⬆️

Calcium ⬆️

Question 4

Surgery for hyperparathyroid

Answer 4

total or partial removal of glands (outpatient endoscopic procedure most common)

Question 5

What to monitor for after removal of parathyroid

Answer 5

hemorrhage
tetany
fluid and electrolyte imbalances

Question 6

Hypoparathyroidism

What is it?
What’s the most common cause ?

Answer 6

decreased PTH and hypocalcemia

•Most common cause is iatrogenic–accidental removal of the parathyroid glands during neck surgery.

Question 7

Treat hypocalcemia related too hypoparathroidism

Answer 7

vitamin D enhances absorption

high calcium foods (dark green veggies, soybeans, tofu)

Question 8

Cushing’s syndrome

What is it too much of ?

Answer 8

clinical condition that results from long-term exposure to excessive corticosteroids, particularly glucocorticoids(cortisol)

• Too much SSS! Salt, sugar, sex hormone

Question 9

Most common cause of cushings

Answer 9

Administer of corticosteroids

Question 10

Cushing syndrome signs

Answer 10

Weight gain (most common)
   - buffalo hump 🦬 moon face 🌝truncal obesity🐘, purple stria 🟣

Muscle wasting 
Delayed wound healing ❤️‍🩹 
Severe acne 
Male characteristics in women (hirsutism 🧔🏼‍♀️)
Feminization in men 👰🏼‍♂️

Question 11

Cushings Treatment depends on cause: If endogenous (internal)

What 3 things can be removed?

Answer 11

• Surgical removal or irradiation of pituitary adenoma
• Adrenalectomy for adrenal tumors or hyperplasia
• Removal of ACTH-secreting tumors

Question 12

Treatment If exogenous (external) cause due to prolonged use of corticosteroids (like Prednisone)

For cushings

Answer 12

Gradually discontinue therapy
Decrease dose
Convert to an alternate-day dosing

Question 13

Home care for cushings

What do they need to wear? And what to use for meds?
What to avoid?
What to teach them?

Answer 13

•Home health nurse
•Always wear Medic Alert bracelet
- use of pill organizer 💊
* 🚫Avoid exposure to extreme Temp, infection, and stress
•Teach how to adjust medication and when to call HCP

Question 14

Addison’s disease

What is it low in ?
What is it caused by ?

Answer 14

LOW SSS

caused by an autoimmune response:
- Autoimmune Adrenalitis (antibodies destroy adrenal cortex)

Question 15

Signs of Addison’s disease

Answer 15

Anorexia 
Nausea progressive weakness 🤢
Fatigue😴
Bronzed colored skin 🥉
Orthostatic Hypotension 😵‍💫
Salt craving 🧂
Diarrhea 💩

Question 16

Addisonian crisis

Answer 16

• Acute adrenal insufficiency
• Insufficient or sudden, sharp decrease in hormones
• Life-threatening emergency 🚨

Question 17

Manifestations of Addisonian crisis

Answer 17

• Hypotension, tachycardia 🫀
• Dehydration 🚱
• ⬇️ sodium, ⬆️ potassium
• severe abdominal pain

Question 18

Addison’s disease Diagnostic Studies

Labs

Answer 18

• ACTH stimulation test
• Corticotropin-releasing hormone (CRH) stimulation test
• both decreased

Question 19

Treatment for Addison’s disease

3 things could be given

Answer 19

Lifelong corticosteroid hormone therapy

1) Hydrocortisone tablets
- has both glucocorticoid and mineralocorticoid properties (Hormone replacement for low cortisol)
2) Fludrocortisone (Florinef)
- replaces mineralocorticoids (aldosterone) often taken together with Hydrocortisone
3) increase dietary salt intake

Question 20

Acute nursing care for Addison’s disease

What to measure ?

Answer 20

•Frequent monitoring necessary

• Correct fluid and electrolyte imbalance
• Assess vitals and neurologic status
• Daily weight ⚖️
• Accurate I and O

Question 21

Patient teaching for Addison’s disease

What 2 things should they carry?
What do they need to learn to give ? 💉
What should they report?

Answer 21

• Report signs of corticosteroid DEFICIENCY and EXCESS to HCP
• Carry identification and wear medical ID bracelet
• Emergency kit 🩹
• How to give IM hydrocortisone💉

Question 22

Dosing for Addison’s disease

Answer 22

1) Glucocorticoids (like Hydrocortisone) in divided doses
2) Mineralocorticoids (like Florinef) once in the morning

**Need to increase corticosteroids during times of stress

Question 23

Teach patient with Addison’s disease to

What to protect from ?

Answer 23

• Guard against infection
• Assist with daily hygiene
• Protect from extremes (light ☀️, noise🎧, temp🥵🥶)

Question 24

Corticosteroid Therapy

1) What does it do ?
2) What needs to be monitored?

Answer 24

1)
Anti-inflammatory
Immunosuppressant

2) Maintenance of BP bc they have orthohypotension

Question 25

Corticosteroid Therapy side effects

Answer 25

Delayed healing
Susceptibility to infections
Suppression of immune response

Question 26

Corticosteroid Therapy
Patient Teaching

Diet?
What to monitor?

Answer 26

Dietary, rest and exercise needs
 - ⬆️ protein, carbs, sodium 
 - Sodium restriction if edema occurs
•Need to monitor for hyperglycemia
•Notify HCP if epigastric pain develops
•Need to prevent injury/infection
•Therapies to reduce osteoporosis