Hypo-parathyroidism

Subject: Medical and Surgical Nursing I (Theory)

Overview

Hypocalcemia brought on by a deficiency in the parathyroid hormone's serum calcium level defines hypoparathyroidism. Its causes could be idiopathic or functional. Its symptoms include hyperphosphaturia, hypocalcemia, elevated serum phosphate levels, and decreased calcium levels. For its therapy, 10% calcium gluconate should be infused intravenously together with dietary calcium supplements, vitamin D, etc. A nurse must closely monitor the patient for hypocalcemia development.

Hypoparathyroidism

It is characterized by hypocalcemia, which is caused by a low level of parathyroid hormone in the serum.

Type

  • Acute and ongoing

Etiology

  • Surgically induced
    • Latrogenic factors are the most typical causes of hypothyroidism. For instance, accidentally removing the parathyroid gland or damaging its vascular supply during neck surgery
  • Idiopathic
    • Resulting from gland atrophy or a lack of fatty replacement.
  • Functional
    • Due to long-term hypomagnesemia, which can manifest as alcoholism or malabsorption.

Pathophysiology

PTH typically works to stimulate bone resorption, which keeps the right amounts of serum calcium stable. PTH controls phosphate clearance via the renal tubules as well, keeping the proper inverse equilibrium between the levels of serum calcium and phosphate.

Clinical Manifestation

  • Reduced resorption of bone
  • Lower calcium levels
  • Greater serum phosphate concentration
  • Hyperphosphaturia and hypocalcemia
  • Increased neuromuscular activity as tetany worsened.

Diagnostic Evaluation

Positive Chvostek's or Trousseaus' signs or both are indicators of latent tetany.

  • Trousseau's sign is a muscle spasm of the hand and wrist brought on by pressure on the upper arm's nerve and blood vessels.
  • A sharp tapping on the facial nerve just in front of the parathyroid gland and anterior to the ear results in spasm or twitching of the lips, nose, and eye, which is the Chvostek sign.
  • Blood test
  • X-ray analyses.

Medical Management

  • 10% calcium gluconate should be administered intravenously with an oral calcium replacement.
  • D vitamin
  • Diet high in calcium and low in phosphate.
  • The parathyroid gland is replaced.
  • Evaluation of laryngeal spasm and seizures.

Nursing Management

  • Carefully monitor the patient for the emergence of hypocalcemia.
  • Ask the patient whether there are any glimmers in their fingertips or around their mouth.
  • Check your hair and skin for any physical changes.
  • Check for enamel hypoplasia in the tooth.

 References

  • emedicine.medscape.com/article/122207-overview
  • endocrineweb.com/conditions/hypoparathyroidism/hypoparathyroidism
  • healthline.com › Reference Library
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
Things to remember
  • It is characterized by hypocalcemia, which is caused by a low level of parathyroid hormone in the serum.
  • A rise in neuromuscular activity as teteny progresses.
  • Evaluation of laryngeal spasm and seizures.
  • Diet high in calcium and low in phosphorus.
  • Check your hair and skin for any physical changes.
Questions and Answers

It is characterized by hypocalcemia, which is caused by a low level of parathyroid hormone in the serum.

Clinical manifestation:

  • Reduced resorption of bone
  • Lower calcium levels
  • Greater serum phosphate concentration
  • Hyperphosphaturia and hypocalcemia
  • A rise in neuromuscular activity as teteny progresses.

Diagnostic evaluation:

Positive Chvostek's or Trousseaus' signs or both are indicators of latent tetany.

  • Trousseau's sign is a muscle spasm of the hand and wrist brought on by pressure being placed on the upper arm's nerve and blood vessels.
  • When a strong tap on the facial nerve right in front of the parathyroid gland and anterior to the ear causes spasm or twitching of the lips, nose, and eye, that is the Chvostek sign.
  • Blood test
  • X-ray analyses.

Medical management

  • 10% calcium gluconate should be administered intravenously with an oral calcium replacement.
  • D vitamin
  • diet high in calcium and low in phosphorus.
  • The parathyroid gland is replaced.
  • Evaluation of laryngeal spasm and seizures.

Nursing management

  • Check the patient carefully for hypocalcemia development.
  • Ask the patient if there are any glimmers in their finger tips or around their mouth.
  • Check your hair and skin for any physical changes.
  • Check for enamel hypoplasia in the tooth.

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