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ENDOCRINE

DISORDER
-PARATHYROID
GLAND-

PRESENTATION BY :
GROUP 3
PARATHYROIDISM

• Two condition :
1. Hyperparathyroidism
2. Hypoparathyroidism
Hyperparathyroi
dism
Definition
• Increase secretion of
parathyroid hormone (PTH)
affecting kidneys, bones.
• Occurs rarely and results in
increased serum calcium.
Pathophysiology
Tumor or hyperplasia of
parathyroid

Resulting
hypercalcemia,hypophosphatemia
Signs & Symptoms
• Asymptomatic
• Behaviors :
- Bone decalcification(increase of
bone fractures)
- Renal calculi
- Abdominal pain, constipation
• Also have metabolic acidosis,
hypocalcemia, dysrhythmias,
muscle weakness.
Diagnostic Test

• Blood test :
-Serum calcium
-Phosphorus
-Magnesium
-Electrolytes
Cont…
• Bone x-rays
• Scans
Treatment
1. Focus on decreasing calcium levels
2. Increase fluid intake, remain
active
3. Avoid calcium supplements,
thiazide diuretics
4. Removal of parathyroid gland
5. Severe hypercalcemia involves
hospitalization & iv saline
Cont…
6. Medication :-
 Alendronate (Fosamax)
 Pamidronate (Aredia)
Nursing Diagnosis
And
Intervention
(hyperparathyroidism)
• Risk for excess fluid volume
related to renal disfunctions

• Closely monitor intake & output.( a loop diuretics


such as Ferosemide may be necessary if urinary
output does not keep up with fluid
administration).

• Frequently assess vital sign , resp status & heart


sounds.(increasing PR ,dyspnea adventitious lung
sounds may indicate excess fluid volume and
potential heart failure.)
Cont…
• Place In semi-fowler to Fowler’s
position (elevating the head of the
bed of improves lung expansion &
reduces the work of breathing )

• Administer diuretics as ordered


,monitoring response ( loop
diuretics may be ordered to help
eliminate excess fluid & calcium. )
Hypoparathyroidi
sm
Definition

• Abnormal low parathyroid


hormones levels.
• Occurs rarely and results in
decreased serum calcium.
Pathophysiology
Due to damage or removal parathyroid
gland during thyroidectomy

Hypocalcemia, elevated blood

Decrease phosphate levels, decrease


activation of vitamin D
Signs & Symptoms
• Numbness
• Tingling around mouth,
fingertips
• Muscle spasms of hand and feet
• Tetany
• Laryngospasms
Diagnostic Test

• Calcium & phosphorus levels , assess


for Chvostek & Trousseau’s signs.
• Rule out other causes of
hypocalcemia (renal
failure,absorbtion or nutritional
disorders).
Treatment
• Treat hypocalcemia
• IV calcium gluconate (severe cases)
• Long-term therapy with
supplemental calcium
• Dietary teaching
• Vitamin D therapy (absorb calcium)
Nursing Diagnosis
and
Intervention
(hypoparathyroidism)
• Risk for injury related to
hypocalcemia

1. Frequently monitor airway & respiratory


status.
2. Report changes such as respiratory
stridor (a harsh inspiratory sound
indicative of upper airway obstruction
increased laryngeal spasm due to tetany.
3. Monitor cardiovascular status including
heart rate and rhythm , blood pressure ,
and peripheral pulse to prevent
bradycardia that can lead to cardiac
arrest in severe hypocalcemia.
4. Continuously monitor ECG in client
receiving iv calcium preparation ,especially
if the client also is taking digitalis, to
prevent digitalis toxicity due to rapid
administration of calcium salt.
5. Provide a quiet environment.Institute
seizure precautions such as raising side
rails & keeping an airway at bedside to
reduce CNS stimuli & the risk of
convulsion in the client with tetany.
THANK YOU
FOR
YOUR
ATTENTION!!