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Parathyroid disorder www..vipinpatidar.wordpress.com 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 www..vipinpatidar.wordpress.com Effects of Parathyroid Hormone www..vipinpatidar.wordpress.com 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 www..vipinpatidar.wordpress.com 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 www..vipinpatidar.wordpress.com 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 www..vipinpatidar.wordpress.com RISK FACTORS • • • • Menopause Sever calcium and vitamin deficiency Radiation therapy Lithium drugs www..vipinpatidar.wordpress.com SYMPTOMS • • • • • • Fragile bones that easily Fracture Skeletal pain, tenderness Kidney Stone Excessive urination Elevated Serum Calcium Level Decrease Phosphorus level www..vipinpatidar.wordpress.com 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, www..vipinpatidar.wordpress.com Surgery • Parathyroidectomy www..vipinpatidar.wordpress.com 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 www..vipinpatidar.wordpress.com 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. www..vipinpatidar.wordpress.com Etiology and risk factors • Iatrogenic (Treatment induce) • Accidental removal of Parathyroid Gland during Thyroidectomy • Idiopathic – like Hashimotos disease www..vipinpatidar.wordpress.com • • • • • • • • • 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 www..vipinpatidar.wordpress.com • • • • Medical Management Calcium Gluconate-10% calcium Gluconate solution in an Intravenous infusion Oral Calcium Replacement Vitamin D High calcium low phosphorus diet www..vipinpatidar.wordpress.com