Hyperparathyroidism PDF
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Summary
This presentation covers hyperparathyroidism, a condition involving overproduction of parathormone. It details clinical manifestations, diagnostic findings, management strategies, and nursing considerations. The presentation also includes information on hydration therapy and pharmacologic approaches.
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Disorders of the parathyroid gland 1 Hyperparathyroidism ⩥ caused by overproduction of parathormone by the parathyroid glands and is characterized by bone decalcification and the development of renal calculi (kidney stones) containing calcium Clinical manifestations Apathy fatigue, muscle weakness n...
Disorders of the parathyroid gland 1 Hyperparathyroidism ⩥ caused by overproduction of parathormone by the parathyroid glands and is characterized by bone decalcification and the development of renal calculi (kidney stones) containing calcium Clinical manifestations Apathy fatigue, muscle weakness nausea, vomiting, constipation hypertension, cardiac dysrhythmias Psychological effects may vary from irritability and neurosis to psychoses ⩥ nephrolithiasis ⩥ ⩥ ⩥ ⩥ ⩥ 3 Assessment and diagnostic findings ⩥ persistent elevation of serum calcium levels and an ⩥ ⩥ ⩥ ⩥ ⩥ ⩥ elevated concentration of parathormone Radioimmunoassays double-antibody parathyroid hormone test Ultrasound MRI thallium scan fine-needle biopsy 4 Surgical management ⩥ Parathyroidectomy ⩥ Surgery is recommended for asymptomatic patients who meet one or more of the following criteria: ⊳ (1) younger than 50 years, ⊳ (2) any patient unable or unlikely to participate in follow up care, ⊳ (3) serum calcium elevations of 1-1.6 mg/dl (0.25-0.4 mmol/liter) above the accepted normal range, ⊳ (4) GFR < 60 mL/min ⊳ (5) urinary calcium level greater than 400 mg/day (10 mmol/day) ⊳ (6) bone density at hip, lumbar spine, or distal radius with T score < -2.5 or previous fracture fragility at any site ⊳ (7) nephrolethiasis or nephrocalcinosis 5 Hydration Therapy ⩥ daily fluid intake of 2,000 mL or more ⩥ Instruct the patient to report other manifestations of renal calculi, such as abdominal pain and hematuria 6 Pharmacologic management ⩥ Lasix- to promote calciuria after rehydration has occurred ⩥ IV saline solutions- expand blood volume and acts in the kidneys to inhibit the reabsorption of the calcium ⩥ Oral or IV phosphate ⊳ Calcitonin ⊳ Mithracin ⊳ Gallium Nitrate 7 Nursing management ⩥ Closely monitor the patient for signs and symptoms of tetany. ⩥ Prevent injury ⩥ Encourage weight bearing 30 mins/day ⩥ Low calcium diet ⩥ Encourage patient to avoid dairy products 8
