hey everyone it's sarah thread sterner sori and.com and in this video I'm going to be going over hypoparathyroidism versus hyperparathyroidism now in the previous videos I went in great detail regarding the passo the causes of signs and symptoms about these two conditions individually so if you haven't watched those videos I highly recommend watching those and a card should be popping up so you can access that playlist now after you watch this video be sure to go to my website register nurse orange calm and take the free quiz that will test your knowledge on hyper versus hypo parathyroid ism so what I want this video to be is a quick review just so you can refer to it if you're fixing to take your NCLEX or a nursing lecture exam so you can see what the differences are between these two conditions so let's get started okay first I learn about hypoparathyroidism what is it it is a low secretion of PTH parathyroid hormone by the parathyroid gland what is hyperparathyroidism it is a high secretion of PTH parathyroid hormone by the parathyroid gland so pretty much they're the opposite of each other what's going on in hypoparathyroidism you're going to have hypocalcemia a low calcium level and a high phosphate level hyper phosphate a Nia on the flip side in hyperparathyroidism you're going to have a high calcium level and a low phosphate level so let's look at the Colossus what causes hypoparathyroidism one cause is there's damage or manipulation to like the thyroid gland or the parathyroid gland and the reason is is because these two glands set close to each other they share the same blood supply so for instance if the patient went had a thyroidectomy they're at risk for experiencing hypoparathyroidism so you'd want to watch their calcium levels another cause is a low magnesium level hypo magnesium eeya the reason is is because the pair magnesium plays a role in how the parathyroid works and if you don't have enough magnesium parathyroid isn't going to work well and I'm going to release PTH another thing autoimmune the body attacks it releases antibodies attacks the plan that doesn't work or the body is resistant to PTH remember we talked about in the past that PTH stimulates your kidneys and your bones to work to release that calcium but here and it's not working the parathyroids releasing the hormone just fine but the kidneys and the bones don't care now let's look at the causes on hyperparathyroidism this is divided into a primary cause and a secondary cause the primary cause is there's something wrong with the gland itself and usually what happens you have hyperplasia which is enlargement of one of those four glands you have a a tumor like an adenoma or a cancer secondary cause it's not the thyroid gland but it's a disease causing the thyroid gland to mess up which a chronic renal failure can do this because your kidneys just aren't working appropriately and that's going to mess up your calcium levels and then your parathyroid is going to be overworked so you're going to experience hyperparathyroidism also hypocalcemia can cause that again because your parathyroid is stimulated by calcium levels so you if you have extensive hypocalcemia you can flip yourself into this condition and bottom and D deficiency so how does the patient look what are those big signs and symptoms that you need to know that will help you distinguish between hypo and hyper parathyroid ism okay size and symptoms um for hypoparathyroidism i like to remember the mnemonic PTH for parathyroid hormone okay P paresthesia this is like that tingling numbness on the lips the fingers the toes they may have a positive trousseau sign or Chobot stick sign technique where you have an involuntary muscle contraction or cramping definitely puts their airway at risk because they can have bronchospasms also their labs are going to have be hypocalcemic and hyper phosphate Amick so you want to look at those how are you going to look in hyper foster parent ism the patient is going to have bone fractures because those bones are just leaking out that calcium because all that excess of PTH stimulating those bones to break down those osteoclasts which performs bone resorption which leaks calcium into the blood so the bones are going to become weak and break constipation GI system is slowing down smooth muscle because calcium plays a role in muscle contraction so it's going to slow down your have constipation renal calculi again just like sense of a mountain calcium and how your kidneys play a role in absorbing that so stone formation nausea and vomiting epigastric pain high calcium levels increase your gastric acid which will cause epigastric pain the nausea and the vomiting and excessive urination again it's causing the kidneys to overwork themselves because of the high calcium now let's look at nursing interventions what are we going to do for this patient as a nurse what's the big things we need to know which includes medications what's positional order okay as a nurse with hypoparathyroidism we are going to monitor the vital signs that airway especially because of the tetiny going on labs administer medications as ordered by the physician and the goal of the medications is to increase the calcium levels because we have hypocalcemia and to decrease those false levels so how does that work okay if the calcium level is severe enough they may order IV calcium like calcium gluconate one thing you want to remember about this is if the patient's on ditch it can increase died jock the dachshund toxicity so remember that another thing is Pio oral calcium medications with vitamin D why with vitamin D because vitamin D helps absorb calcium and the side effect of this could be GI upset constipation and increased chances of renal stones another medication is phosphate binders because remember in this condition we have hyper phosphate emia so just as a not name says it's going to be phosphate binders and how do these work and one drug is called aluminum carbonate it's really neat and what it does is it takes the false that you're eating and the food and puts it in your stool and uux crew it out and so you would want to administer this medication with food and last but not least parathyroid hormone replacement these patients are deficient on PTH so you can give it to them medication is called nat para it's an injection however you want to walk monitor the calcium levels with this for any GI upset or paresthesia okay so what are the nursing interventions for hypoparathyroidism nursing interventions would include to monitor the bottle signs strain the urine for any kidney stones assess the patient if they may be having to pass a kidney stone like that excruciating flank pain encourage fluids as tolerated however watch this in your patients with congestive heart failure or renal failure because they can't tolerate lots of fluids um however it will prevent dehydration and the chances of a renal stone forming one treatment includes surgical treatment would be a parathyroidectomy and this is usually treatment for the main cause of the primary timelike enlargement of one of those Glen an adenoma or cancerous tumor and they would go in and remove the gland that's affected so you'd want to prep the patient for that and in the previous videos we talked in depth about that another thing physicians may order medications and as the nurse you will administer those and the goal of the medications is to decrease calcium levels decrease parathyroid hormone levels and to keep the patient hydrated so some medication treatments would include IV solution therapy like normal saline matches for a hydration medications call cassimy medics also known as since apart and this is usually a treatment for patients who are experiencing secondary cause with chronic renal failure and what this medication does is it goes in and it mimics the role of calcium which tricks the parathyroid into thinking those calcium levels are great so it quits releasing so much PTH so it brings down your calcium levels and your parathyroid hormone levels another medication calcitonin and it works by decreasing the calcium levels and protecting the bones another drug loop diuretics like lasix what this does is it decreases the calcium levels by inhibiting calcium reabsorption in those renal tubules also with lasix of course watch your potassium because it wastes potassium and last but not least by fall spades also some popular ones are Aradia or false Max and what these by phosphate students they slow down osteoclast activity which breaks down the bones and increases osteoblast activity which builds up the bones so you're going to build the bones up and protect them however one thing you want to remember if you are giving a patient Fosamax is that they take it all others by itself and on an empty stomach no food with a full glass of water and that they set up for at least 30 minutes after taking it because this medication is very hard on the stomach and the esophagus and it can cause ulcers okay so that is hyper parathyroid ism versus hypoparathyroidism now go to my website register nurse or in comm and take that free quiz I will test your knowledge on these two conditions and be sure to check out my other NCLEX endocrine reviews and thank you so much for watching and please consider subscribing to this YouTube channel