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Parathyroid disorder
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Parathyroid Glands
• Tiny glands
• Four parathyroid glands
embedded in the
posterior aspect of the
thyroid
– Chief (principal) cells
secrete PTH
(parathyroid hormone)
– PTH regulates calcium
balance in the blood
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Effects of Parathyroid Hormone
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Figure 16.11
HYPERPARATHYROIDISM
• A Disorder caused by over activity of one or
more parathyroid gland.
• It classified as primary and secondary
• Usually occurs client older than 60years
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ETIOLOGY AND RISK FACTORS
Primary Hyperparathyroidism
Occurs because of enlargement of 2 or 4 gland
• Non-cancerous growth (Adenoma)
• Hyperplasia of two or more parathyroid gland
• Malignant tumor is a rare
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Secondary Hyperparathyroidism
• Occurs when the gland are hyperplastic
because of malfunction of another organ
system.
• Parathyroid glands overwork to compensate
for loss of calcium e.g. Renal failure
• Sever Calcium Deficiency
• Sever Vitamin D Deficiency
• CRF
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RISK FACTORS
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Menopause
Sever calcium and vitamin deficiency
Radiation therapy
Lithium drugs
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SYMPTOMS
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Fragile bones that easily Fracture
Skeletal pain, tenderness
Kidney Stone
Excessive urination
Elevated Serum Calcium Level
Decrease Phosphorus level
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Outcome Management
Lower Elevated calcium Level
• Hydration can be achieved with an infusion of
normal saline solution. (2000ml)
• Cranberry juice is suggested because it lower
urinary pH.
• Mobility –bed rest increases calcium excretion
and the risk for renal calculi
• Diet –avoid excess calcium,
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Surgery
• Parathyroidectomy
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Nursing Diagnosis
• Risk for injury related to demineralization of
bones resulting in Pathologic Fracture
• Impaired urinary Elimination related to renal
involvement
• Imbalance nutrition less than body
requirements related to anorexia
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Hypoparathyrodism
• Hypo secretion of parathyroid gland produce
Hypoparathyrodism
• That is, Serum calcium levels are abnormally
low, serum phosphate levels are abnormally
high, and Pronounced neuromuscular
irritability (tetany) may develop.
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Etiology and risk factors
• Iatrogenic (Treatment induce)
• Accidental removal of Parathyroid Gland
during Thyroidectomy
• Idiopathic – like Hashimotos disease
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SIGNS AND SYMPTOMS
Tingling or burning in fingertips, Toes and lips
Muscle aches or cramps affecting to legs, feet or face
Chvostek signs (spasm on facial muscles after tap over
the facial nerve
Trousseaus Sign (carpopedal spasm is induced by
occluding the blood flow to the arm for 3 min)
Fatigue
Pain full menstruation
Brittle Nail
Headache
Depression
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Medical Management
Calcium Gluconate-10% calcium Gluconate
solution in an Intravenous infusion
Oral Calcium Replacement
Vitamin D
High calcium low phosphorus diet
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