Parathyroid Glands

Question 1

Parathyroid Glands

Answer 1

• Produce Parathyroid Hormone (PTH)
• Regualte calcium & phosphorus metabolism: suppose to incr serum calcium concentration & dcr serum phosphate
  > if calcium is incrd, phos is dcrd
  > if calcium is dcrd, phos is incrd

Question 2

Hyperparathyroidism

Answer 2

• Excessive secretion of PTH
  > causes incr calcium in blood, bone decalcification, & renal calculi

Question 3

Hyperparathyroidism - CMs

Answer 3

• Fatigue
• Muscle weakness
• Constipation
• Skeletal pain
• HTN
• Dysrhythmias
• Peptic ulcers
  > build up of Ca
• Pancreatitis

Question 4

Hyperparathyroidism - Diagnosis

Answer 4

• Elevated Ca
• X-ray/scans

Question 5

Hyperparathyroidism - Medical Management

Answer 5

• Diuretics, fluids, mobility, diet restriction
  > Ca rich foods: dairy, leafy greens, fish
• Meds
  > phosphates, calcitonin
• Surgery

Question 6

Parathyroidectomy - Nursing Pre-Op

Answer 6

• Pt stabilized
  > Ca lvls normalized
• Studies
  > bleeding & clotting times
  > CBC
• Teaching
  > limit coughing
  > practice deep breathing
  > neck support

Question 7

Parathyroidectomy - Nursing Post-Op

Answer 7

• Observe for resp distress
  > keep emergency equip at bedside
• Hypocalcemia crisis can occur
  > watch for tetany, seizures
  > Trousseau’s sign when taking BP
• Recurrent laryngeal nerve damage

Question 8

Hypoparathyroidism

Answer 8

• Dcrd PTH secretion
  > lack of hormone causes incr phosphate & dcr Ca (5-6mg/dL)
• Common cause: inadvertent removal of gland during removal of thyroid or radical neck surgery
• Medical
  > correcting hypocalcemia, vit D deficiency
  > keep pt in quiet envir’t free of bright lights & drafts to dcr neurologic stimuli