parathyroid disorders
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| parathyroid pathophysiology? | maintain calcium and phosphate balance. PTH acts on receptors in kidney, bone, and intestine to increasse calcium release
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| purpose of parathyroid? | absolute control over calcium levels throughout body
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| normal calcium levels? | 9-11
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| hyperparathyroidism definition? | increased secretion of parathyroid hormone(PTH) affecting kidneys and bones. occurs rarely and results in increased serum calcium
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| hyperparathyroidism's common cause? | benign tumore of 1 gland
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| high levels of calcium cause? | renal calculi, Ca deposits in kidneys, bone lesions/fractures, GI disturbances, psychosis/confusion
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| 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
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| Pre-op care after surgery for hyperparathyroidism? | try to stabilize Ca levels
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| 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
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| 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
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| 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
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| 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)
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| nonsurgical therapy? | diuretics, calcimemtic agents, biphosphonates-inhibits bone reasportion(fosomax), calcitonin, annual exam, high fluid intake, moderate calcium intake
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| calcitonin? | decreases skeletal release of Ca and increases kidney excretion
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| hypoparathyroidism? | rare-most common after OR(Sx of thyroid or parathyroid), causes hypomagnesemia-suppression of PTH secretion
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| hypoparathyroidism is seen in pt's with... | ETOH use, CRF, malnutrition and malabsorption
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| normal magnesium levels? | 1.5-2.5
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| hypomagnesemia s/s? | confusion, tremors, seizure, hyperrelexia, positive trousseau's & chvosteks sign, tachy cardia, HTN, dysrhthmia's, dysphagia
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| treatment of hypomagnesemia? | oral magnesium suppl, magnesium rich foods, monitor for seizures, cardiac status, assess swallowing, alcohol rehab program
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| 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
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| clinical manifestations of hypoparathyroidism? | tingling of lips, fingertips and feet, increased muscle tension, dysphagia, postive chvostek's & trousseau's sign, hair loss, and seizures
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| 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
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