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Nursing 4 Exam 1

parathyroid disorders

parathyroid pathophysiology? maintain calcium and phosphate balance. PTH acts on receptors in kidney, bone, and intestine to increasse calcium release
purpose of parathyroid? absolute control over calcium levels throughout body
normal calcium levels? 9-11
hyperparathyroidism definition? increased secretion of parathyroid hormone(PTH) affecting kidneys and bones. occurs rarely and results in increased serum calcium
hyperparathyroidism's common cause? benign tumore of 1 gland
high levels of calcium cause? renal calculi, Ca deposits in kidneys, bone lesions/fractures, GI disturbances, psychosis/confusion
diagnostic tests for hyperparathyroidism? serum PTH, Ca, and phosphate. bone density-dual energy X-ray absorptiometry(DEXA scan). X-rays, MRI/CT(head & neck), U/S
Pre-op care after surgery for hyperparathyroidism? try to stabilize Ca levels
Intra-op care for pt who has hyperparathyroid surgery? remove tumor from 1 gland, 3 glands and part of 4th gland w/hyperplasia, 4 removed may implant small section in forearm
post op care after sx for hyperparathyroid? support head to prevent post-op pain & stress on suture line, position client in semi-fowlers w/head & neck supported by sandbags & pillows, assess for s/s resp obstruction, trach at bedside
hypercalcemia s/s? confusion, decreased memory, depressed deep tendon reflex, muscle weakness, fatigue, bone pain, fx's, constiopation, anorexia, n/v, cardiac dysrhthmias, renal calculi
treatment for hypercalcemia? loop diuretic, isotonic IV fluids, calcitonin, 3000-4000ml oral fluids daily, encourage acid fluids(cran juice), low calcium diet, wt bearing exercises(will also push calcium back into bones)
nonsurgical therapy? diuretics, calcimemtic agents, biphosphonates-inhibits bone reasportion(fosomax), calcitonin, annual exam, high fluid intake, moderate calcium intake
calcitonin? decreases skeletal release of Ca and increases kidney excretion
hypoparathyroidism? rare-most common after OR(Sx of thyroid or parathyroid), causes hypomagnesemia-suppression of PTH secretion
hypoparathyroidism is seen in pt's with... ETOH use, CRF, malnutrition and malabsorption
normal magnesium levels? 1.5-2.5
hypomagnesemia s/s? confusion, tremors, seizure, hyperrelexia, positive trousseau's & chvosteks sign, tachy cardia, HTN, dysrhthmia's, dysphagia
treatment of hypomagnesemia? oral magnesium suppl, magnesium rich foods, monitor for seizures, cardiac status, assess swallowing, alcohol rehab program
magnesium rich foods include? bran(rice,wheat,& oat), dried herbs, squash, pumpkin & watermelon seeds, cocoa pwder(dark choc), flax, sesame seeds and sesame butter, brazil nuts, sunflower seeds, almonds & cashews, molasses, roasted soybeans, halibut, tuna
clinical manifestations of hypoparathyroidism? tingling of lips, fingertips and feet, increased muscle tension, dysphagia, postive chvostek's & trousseau's sign, hair loss, and seizures
treatment for hypoparathyroidism? correct Ca, vit D, and/or Mg deficiency, increase Ca and decrease phosphorus in diet, treatment is lifelong and medica-alert recommended
Created by: jbittner