Hyperparathyroidism

Subject: Medical and Surgical Nursing I (Theory)

Overview

Overactive parathyroid glands are the cause of hyperparathyroidism. Hyperplasia from prolonged renal calcium malabsorption increased serum calcium, etc. It manifests itself differently in each body system. Diagnostic procedures include blood testing, ultrasound, magnetic resonance imaging, and computed tomography. It is treated by removing the parathyroid glands. Patient and family education includes routine monitoring of respiratory, cardiovascular, neurological, and fluid volume status. Analyze the hormonal setting and postoperative treatment options. Its consequences include hemorrhage, renal failure, and others.

It's a condition wherein the parathyroid glands become overactive. Primary, secondary, and tertiary categories exist. Clients aged 30–70 years old are more likely to experience this.

Etiology

  • Increased serum calcium
  • Hyperplasia due to malabsorption of chronic renal
  • Failure
  • Adenoma

Clinical manifestation

  • Cardiovascular system
    • Arrhythmia
    • Hypertension
  •  Gastrointestinal system
    • Abdominal pain
    • Nausea
    • Anorexia
    • Vomiting
    • Constipation
    • Diarrhea
    • Weight loss
  • Integumentary system
    • Skin necrosis
    • Monist skin’
  • Musculoskeletal system
    • Muscle pain
    • Back pain
    • Weakness
    • Osteoporosis
  • Neurologic system
    • Psychosis
    • Memory loss
  • Renal system
    • Hypercalcemia
    • Urinary tract infection
    • Polyuria
    • Kidney stone

Diagnostic evaluations

  • Ultrasonography
  • MRI
  • CT scan
  • Blood examination for calcium(increased), phosphate (decreased), and elevated PTH level.
  • 24 hours urinary calcium excretion.

Surgical management

  • Parathyroidectomy

Medical management

  • Diuretics for the excretion of calcium
  • Adequate hydration
  • Antiresorptive agents e.g- Plicamycin, glucocorticoids.
  • Restriction of calcium in the diet.
  • Administration of oral phosphate.
  • Antihypercalcemia agents.

Nursing management

  • Preoperative
    • Assess the hormone environment and availability of care after surgery.
    • Monitor vital signs.
    • Adequate fluid intake and NPO
    • Psychological preparation.
  • Postoperative
    • Availability of tracheostomy set for emergency use.
    • The serum calcium level decreased within 24 hrs
    • The patient should be monitored for tetany.
    • Monitor the intake output chart.
    • Patient and family education includes routine monitoring of respiratory, cardiovascular, neurological, and fluid volume status.

Complication

  • Hemorrhage
  • Fluid and electrolyte disturbance
  • Renal failure
  • Pancreatitis
  • Demineralization of bones

 References

Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
emedicine.medscape.com/article/127351-overview

 
 
Things to remember

 

  • The condition manifests as abnormally high levels of parathyroid hormone production.
  • Clients older than 30–70 years of age are more likely to experience this.
  • Analyzing blood for excessive calcium, reduced phosphate, and increased parathyroid hormone (PTH).
  • To remove calcium from the body, diuretics are used.
  • Pre-surgery NPO and enough fluid intake
  • A tracheostomy kit is on hand in case of an unexpected medical emergency.
Questions and Answers

Hyperparathyroidism is a condition in which one or more parathyroid glands are overactive. It is divided into three levels: primary, secondary, and tertiary. It mainly affects clients between the ages of 30 and 70.

Etiology:

  • Serum calcium levels have risen.
  • Hyperplasia caused by chronic renal malabsorption
  • Failure
  • Adenoma

Clinical manifestation:

  • Cardiovascular system:

    • Arrhythmia
    • Hypertension

  • Gastrointestinal system

    • Abdominal pain
    • Nausea
    • Anorexia
    • Vomiting
    • Constipation
    • Diarrhea
    • Weight loss

  • Integumentary system:

    • Skin necrosis
    • Monist skin

  • Musculoskeletal system:

    • Muscle pain
    • Back pain
    • Weakness
    • Osteoporosis

  • Neurologic system:

    • Psychosis
    • Memory loss

  • Renal system:

    • Hypercalcemia
    • Urinary tract infection
    • Polyuria
    • Kidney stone

Nursing management:

  • Pre operative:

    • After surgery, evaluate the hormonal environment and the availability of care.
    • Observe the vital signs.
    • NPO and adequate fluid intake
    • psychological getting ready

  • Postoperative:

    • A tracheostomy set that can be used in an emergency
    • Within 24 hours, the serum calcium level dropped, and the
    • Tetany should be kept an eye on in the patient.
    • Keep an eye on the intake-output chart.
    • Regular patient and family education includes routine monitoring of the patient's respiratory, cardiovascular, neurological, and fluid volume states.

 

 

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