Hypoparathyroidism

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Study Tools For Hypoparathyroidism

Endocrine System Study Chart (Cheatsheet)
Hypoparathyroidism (Picmonic)
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Outline

Overview

  1. Hypoparathyroidism
    1. Underactive parathyroid glands
    2. Low PTH levels

Nursing Points

General

  1. Parathyroid gland releases parathyroid hormone (PTH)
  2. Hypoparathyroidism = less PTH
  3. Purpose of PTH
    1. Bones release calcium into blood
    2. Intestines absorb calcium
    3. Kidneys retain calcium
    4. Kidneys excrete phosphorus out in urine
  4. Not enough PTH
    1. Decreased calcium levels –>increased nerve excitability –>tetany (muscle spasms)
      1. Seizures
      2. Arrhythmias
    2. Increased phosphorus levels
  5. Causes of hypoparathyroidism
    1. Surgery
    2. Autoimmune disease
    3. Genetics
    4. Radiation

Assessment

  1. Presentation
    1. Muscle spasms
      1. Bronchospasms –> difficulty breathing
    2. Tingling/numbness
      1. Around mouth
      2. Fingers
    3. Muscle aches
    4. Fatigue
    5. Seizures
    6. Irregular heart rhythm
  2. Doctor orders
    1. Calcium level
    2. PTH level
    3. Phosphorus level

Therapeutic Management

  1. Calcium supplements
  2. Vitamin D supplements
  3. Cardiac monitoring –>watch rhythm
  4. Anti-epileptic medications

Nursing Concepts

  1. Hormone Regulation –> low parathyroid hormone levels (PTH)
  2. Nutrition
    1. Low calcium –> need food high in
    2. High Phosphorus –> need food low in
  3. Patient Education –> choose foods carefully

Patient Education

  1. Eat foods rich in calcium
    1. Dairy
    2. Green leafy veggies
    3. Orange juice
  2. Limit phosphorus rich food
    1. Meat
    2. Whole grains
    3. Carbonated beverages
  3. Follow up blood tests twice per year

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Transcript

Hey guys! In this lesson we’ll explore what hypoparathyroidism is and what happens in the body.

So with hypoparathyroidism, the parathyroid glands are underactive, meaning they aren’t making enough of the parathyroid hormones or PTH. Let’s explore what PTH does normally for our body.

So PTH has many functions. It makes the bones release calcium into the blood. It makes the intestines absorb calcium and the kidneys retain calcium. PTH also tells the kidneys to excrete phosphorus out in urine. So in hypoparathyroidism, there is less PTH, so let’s explore what happens in the body with less PTH.

Less PTH results in less calcium in the body, which in turn increases nerve excitability. This means there are increased impulses sent through the nervous system, which affects the nerves and muscle movement. For example, the patient with hypoparathyroidism may have tetany, or muscle spasms. The increased impulses could cause seizures or heart arrhythmias. Without enough PTH to tell the kidneys to excrete phosphorus, the phosphorus levels in the body will increase. Next let’s talk about the causes of hypoparathyroidism.

Hypoparathyroidism may be caused by the surgery, like if the patient had hyperparathyroidism and had to have the parathyroid glands removed. Autoimmune diseases can cause antibodies to attack to glands causing injury and decreased PTH production. Those with family histories of the disease are more likely to get it. Radiation to treat cancer can also injure the glands. Next we will talk about what the patient looks like.

So the patient will likely have muscle spasms from that increased nerve excitability. This includes spasms in the lungs known as bronchospasms. This can make it hard to breath. Tingling and numbness can occur around the mouth and in the fingers. The patient may feel tired and experience seizure or heart palpitations.

So if the patient is having those symptoms, the doctor may order a lab draw to test the calcium, PTH, and phosphorus levels to help diagnose the disease. If the patient is then diagnosed, we will begin management of hypoparathyroidism.

So to help manage the disease, we will administer calcium and vitamin D supplements. Remember that vitamin D is needed for the body to absorb calcium. Cardiac monitoring may be ordered to watch the rhythm of the heart. Anti-epileptic medications may be ordered to prevent or stop seizures.

The patient with hypoparathyroidism will need education on what they can and cannot eat. We should encourage foods high in calcium like dairy, green leafy veggies, and orange juice. The patient should limit food that is high in phosphorus like meat, whole grains, and carbonated beverages. It’s important that they follow up with blood tests twice a year to keep an eye on the PTH levels.

Our priority nursing concepts for the patient with hypoparathyroidism include hormone regulation, nutrition, and patient education.

Okay, now let’s review the key points from this lesson. Hypoparathyroidism involves underactive parathyroid glands which results in low PTH. Less PTH means less calcium in the blood, resulting in increased nerve excitability. This can cause seizures, tetany or muscle spasms, and heart arrhythmias. The doctor may order labs to help diagnose the disease like PTH, calcium, and phosphorus levels. Hypoparathyroidism is managed with Calcium and vitamin D supplements, anti-seizure medications, and PTH lab work as ordered by the doctor. We should encourage our patients to eat foods high in calcium like dairy and green leafy veggies, and eat foods low in phosphorus like meat.

That’s it for the lesson on hypoparathyroidism! No go out and be your best self today, and as always, happy nursing!



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NUR 275 Exam 2

Concepts Covered:

  • Eating Disorders
  • Disorders of Pancreas
  • Labor Complications
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Shock
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Disorders of Thermoregulation
  • Endocrine and Metabolic Disorders
  • Urinary System
  • Immunological Disorders
  • Respiratory Emergencies
  • Pregnancy Risks
  • Medication Administration
  • Cardiovascular Disorders

Study Plan Lessons

Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Hypertonic Solutions (IV solutions)
Isotonic Solutions (IV solutions)
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Nursing Care and Pathophysiology for Hyperparathyroidism
Hypoparathyroidism
Metabolic/Endocrine Course Introduction
Metabolic & Endocrine Module Intro
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Diabetes Mellitus (DM) Module Intro
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Hyperthermia (Thermoregulation)
Hypothermia (Thermoregulation)
Hypoglycemia
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Nursing Care and Pathophysiology for Scleroderma
Fluid Volume Overload
Fibromyalgia
Chest Tube Management
Furosemide (Lasix) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Antidiabetic Agents
Antidiabetic Agents
Injectable Medications
Insulin – Short Acting (Regular) Nursing Considerations
Insulin
IV Infusions (Solutions)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Corticosteroids
Insulin Drips
Dopamine (Inotropin) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Vasopressin
Vasopressin (Pitressin) Nursing Considerations
Cortisone (Cortone) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Trauma Module Intro
Asthma
Nursing Care and Pathophysiology for Asthma