Understanding Parathyroid Disorders and Care

Nov 14, 2024

Mindmap

Lecture on Hypoparathyroidism and Hyperparathyroidism

Overview of Parathyroid Glands

  • Location: 4 parathyroid glands next to the thyroid.
  • Function: Release parathyroid hormone (PTH) to increase calcium levels in blood through:
    • Pulling calcium from bones.
    • Increasing calcium reabsorption in kidneys.
    • Increasing calcium absorption in intestines.

Hypoparathyroidism

  • Definition: Decreased secretion of PTH.
  • Main Cause: Often due to damage during thyroidectomy.
  • Symptoms: Similar to hypocalcemia:
    • Muscle cramps, numbness, tingling.
    • Positive Chvostek's sign and Trousseau's sign.
    • Tetany, seizures, dysrhythmias.
  • Laboratory Findings:
    • Decreased PTH.
    • Hypocalcemia (calcium < 9).
    • Hyperphosphatemia (inverse relationship between calcium and phosphorus).
  • Treatment:
    • Calcium gluconate.
    • Vitamin D supplements.
    • Phosphate binders.
  • Nursing Care:
    • Seizure precautions (pad side rails, oxygen availability).
    • High-calcium, low-phosphorus diet.
    • Phosphate binders with meals.

Hyperparathyroidism

  • Definition: Excessive secretion of PTH.
  • Causes:
    • Primary: Adenoma (benign tumor on parathyroid gland).
    • Secondary: Kidney disease, causing compensatory PTH secretion.
  • Symptoms: Similar to hypercalcemia:
    • Fatigue, muscle weakness.
    • Bone pain, deformities.
    • Nausea, vomiting, constipation, weight loss.
    • Hypertension, kidney stones, dysrhythmias.
  • Laboratory Findings:
    • High PTH levels.
    • High calcium levels.
    • Low phosphorus levels.
  • Treatment:
    • Furosemide (Lasix) to increase calcium excretion.
    • Calcitonin to lower calcium levels.
    • Phosphates to increase phosphorus levels.
    • Possible parathyroidectomy for adenomas.
  • Nursing Care:
    • Safety precautions (assist ambulation, fall prevention).
    • Low-calcium, high-phosphorus diet.
    • Increase fluid intake to prevent constipation and kidney stones.

Conclusion

  • The session covered the disorders of hypoparathyroidism and hyperparathyroidism, their causes, symptoms, laboratory findings, treatments, and nursing care.
  • Next topic: Diabetes.

Note: Ensure understanding of calcium and phosphorus balance in these disorders for effective management.