Parathyroid

Question 1

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?

Answer 1

Sometimes in thyroid surgery, the parathyroid glands are removed, producing a disturbance in calcium metabolism. Tetany is usually treated with IV calcium gluconate

Question 2

What is hypo parathyroid disorder?

Answer 2

A disorder in which there is low PTH resulting in LOW calcium and high phosphate
Remember calcium and phosphate are opposite
Hypocalcemia = TETANY

Question 3

What is tetany?

Answer 3

Tetany is:
intermittent muscle spasms
laryngeal spasms making it difficult to speak and breathing problems
Cardiac issues
tingling/numbness is hands, feet, perioral area
can lead to seizures

Question 4

Causes of hypo parathyroid

Answer 4

Deficiency of parathyroid gland secretion which can be from:
damage to gland (autoimmune) idiopathic or hereditary
radiation therapy
Thyroidectomy which is also removal of the parathyroid

Question 5

s/s acute hypo parathyroid

Answer 5

Tetany!
Tingling and numbness of face, hands, feet (parathesis)
Muscle spasms
Laryngeal spasms- stridor
\+ Trousseaus sign
\+ Chvostek sign
Seizures

Question 6

s/s chronic hypo parathyroid

Answer 6

Fatigue, weakness, muscle cramps
Memory impairment, personality changes, irritability
Cataract formation
Dry scaley skin, hair loss, loss of tooth enamel

Question 7

Dx for hypo parathyroid

Answer 7

LOW calcium
LOW PTH
High phosphate
X ray revels bone density- remember bones and stones for Hyper- which means bones are weak

Question 8

Treatment for hypo parathyroid

Answer 8

Emergency/acute- for tetany
Calcium gluconate or calcium chloride IV

Chronis- oral calcium preparations such as carbonate or citrate with food
Vit D helps with absorption from Gi tract

Question 9

Nursing interventions for hypo thyroid

Answer 9

Trach set and calcium gluconate @ bedside!
Monitor labs for low calcium and high phosphate
Assess for s/s of hypocalcemia such as tetany

Question 10

Hyper para thyroid

Answer 10

Excessive secretion of PTH, creating increased calcium serum and decrease phosphate
Bone metabolism change = bone demineralization= weak bones!
More common in women, 35-65

Question 11

Causes of hyper parathyroid

Answer 11

Primary- tumor or hyperplasia
Secondary- compensatory oversecreting of PTH in response to hypocalcemia in :
renal disease, rickets and malabsorption
response in increased calcium reabsorption from kidneys and demineralization of bone

remember- bones and stone with hypercalcemia

Question 12

S/S of hyper parathyroid

Answer 12

BONES AND STONES
Back ache, deep bone pain, bone cysts, osteoporosis/bone demineralization
Renal calculi, renal damage, hematuria and flank pain
N/V, anorexia, constipation, muscle weakness and fatigue

Question 13

DX of hyper parathyroid

Answer 13

Increased calcium and PTH
Decreased phosphate
X ray shows bone demineralization