Hypoparathyroidism.pdf

Disorders of the parathyroid gland 1 hypoparathyroidism ⩥ Deficiency of PTH due to hyposecretion of parathyroid gland ⩥ Serum calcium levels are abnormally low, serum phosphate levels are abnormally high and pronounced neuromuscular irritability (tetany) may develop. 9 causes ⩥ Iatrogenic ⊳ Surgery...

Disorders of the parathyroid gland 1 hypoparathyroidism ⩥ Deficiency of PTH due to hyposecretion of parathyroid gland ⩥ Serum calcium levels are abnormally low, serum phosphate levels are abnormally high and pronounced neuromuscular irritability (tetany) may develop. 9 causes ⩥ Iatrogenic ⊳ Surgery (thyroidectomy) ⊳ Infarction of the parathyroid glands because of inadequate blood supply during surgery ⩥ Idiopathic/autoimmune disorder 10 Physical assessment ⩥ Acute hypoparathyroidism ⊳ Positive Chvostek’s Sign and Trousseau Sign ⊳ Hyperactive Deep tendon reflexes ⊳ Paresthesia: numbness and tingling of fingers 11 Physical assessment ⩥ Chronic hypoparathyroidism ⊳ Lethargy, weakness, fatigue ⊳ Thin, patchy hair ⊳ Brittle nails ⊳ Dry scaly skin ⊳ Cataract ⊳ Permanent brain damage 12 Diagnostic findings ⩥ ⩥ ⩥ ⩥ ⩥ ⩥ Decreased serum calcium levels (1.75 mEq/L) Low PTH levels Decreased urine calcium Ophthalmic exam: calsification of lens Radiograph- increased bone density of skull 13 Medical management ⩥ Active form of vitamin D ⊳ Rocatrol ⊳ Hytakerol (Dihydortachysterol) ⩥ IV Calcium ⊳ 10% Calcium Chloride and Calcium gluconate ⩥ Supplemental calcium (oral, dietary) ⩥ Parathyroid hormone replacement 14 Nursing management ⩥ Teach the patient to consume high calcium, low phosphate diet ⩥ Avoid milk and cheese (high in phosphorus) ⩥ Assess for signs of tetany ⩥ Implement seizure precautions ⩥ Maintain patent airway, keep trachea set at bedside ⩥ Keep ampule of IV calcium at bedside 15