NURS 232 MEDICAL CONDITIONS OF THE

INTEGUMENTARY, GASTROINTESTINAL
AND ENDOCRINE SYSTEMS

Session Seventeen Diseases of

the Parathyroid Gland
Lecturer: Dr. Kwadwo Ameyaw Korsah, UG, SON
Contact Information: kakorsah@ug.edu.gh

College of Education
School of Continuing and Distance Education
2014/2015 2016/2017

Session Overview
Session 17 covers abnormalities of the
parathyroid gland namely hyperparathyroidism
and hypoparathyroidism.
Students are thought how to recognize these
conditions and assist in the management of
patients suffering from them.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 2

Session Objectives
At the end of the session, the student should
be able to:
Identify patients suffering from disorders
of the parathyroid gland.
Offer appropriate nursing management for
these patients

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 3

Session Outline
The key topics to be covered in the session are as
follows:
Topic One hyperparathyroidism
Topic Two hypoparathyroidism

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 4

Topic One

HYPERPARATHYROIDISM

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 5

Disorders of the parathyroid gland

Introduction
There are four parathyroid glands situated on the
anterior neck, posterior to the thyroid gland.
Occasionally, other parathyroid glands may be
found in other parts of the neck.
Each gland is of the size of a grain of rice.
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 6

Introduction contd
The parathyroid glands secretes parathyroid

hormone (PTH), parathormone or parathyrin

The parathyroid hormone helps to regulate

calcium homeostasis, phosphorus and vitamin

D levels within the bones and blood.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 7

Introduction contd
The parathyroid hormone acts to increase
the level of calcium in the blood.
Calcitonin, a hormone produced by the
parafollicular cells in the thyroid gland
acts to decrease the calcium concentration
in the blood
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 8

hyperparathyroidism
The parathyroid gland secrets too much
parathyroid hormone.
High levels of PTH causes blood calcium levels to
rise (hypercalcaemia) and low serum phosphorus
levels (hypophosphataemia).
Hyperparathyroidism can be primary or secondary.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 9

Causes
Primary hyperparathroidism is of unknown
cause though it appears that adenomas or
enlargement of the parathyroid glands
may be a cause.
Secondary hyperparathyroidism is a
physiological compensatory hypertrophy
of all parathyroids because of
hypocalcaemia.
Hypocalcaemia occurs in renal failure or
vitamin D deficiency.
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 10

Signs and symptoms

Tiredness
Muscle weakness
Depression
Dehydration
Bone pains
Loss of concentration

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 11

Investigations
Fasting serum calcium and phosphate
test. This may reveal high levels of serum
calcium and low serum phosphate levels.
Serum PTH test. This normally reveals
high levels of PTH.
Ultrasound scan may also show calcium
deposits or kidney stones.
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 12

Management
Encourage high fluid intake.
Decrease calcium and vitamin D intake.
Encourage moderate physical exercise
such as brisk walking and jogging.
Surgery may be done to remove some
parathyroid glands.
Drugs such as calcitonin is also useful.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 13

Complications of
hyperparathyroidism
Osteoporosity and bone fractures.
Peptic ulcer
Pancreatitis

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 14

Topic Two

HYPOPARATHYROIDISM

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 15

Hypoparathyroidism
When the serum levels of the parathyroid hormone is
too small, it is termed hypoparathyroidism.
Most patients with hypoparathyroidism have low blood
calcium levels (hypocalcaemia) and high blood
phosphorus levels (hyperphosphataemia).

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 16

Causes
Destruction of parathyroid tissue
Postsurgical
Postradiation
Autoimmune
Metastatic infiltration
Heavy metal deposition eg Iron
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 17

Causes contd
Reversible impairment in parathyroid
hormone secretion or action
Hypomagnesemia and Hypermagnesemia
Resistance to parathyroid hormone action
Pseudohypoparathyroidism
Genetic disorders of parathyroid
hormone synthesis
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 18

Clinical Manifestations

Paraesthesia
Dry, thick skin
Coarse and brittle hairs
Impaired vision
Premature cataracts
Palpitations
Dysarrhythmias
Muscle twitching

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 19

Diagnosis
Serum calcium test may reveal low blood
calcium levels.
Serum PTH levels estimation may show
significant low blood levels.
Serum phosphorus estimation may also
show high blood phosphorus levels.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 20

Management
The aim of treatment is to bring the blood
levels of calcium to normal (2.12.50mmol/L)
Calcium carbonate and vitamin D
supplements such as calcitriol (rocaltrol) is
useful.
Diet high in calcium and low phosphorus.
Let us look at some examples below:
Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 21

Management contd
Good sources of calcium are: milk,
cabbage, soya beans etc.
Sources of phosphorus are: red meat,
dairy foods, fish and poultry.

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 22

Complications

Stunted growth.
Cataracts.
Poor teeth development.
Slow mental development.

Others

Dr. Kwadwo Ameyaw Korsah, UG, SON

Slide 23

Reference
Van De Graff, K. M., Fox, S. I., & Lafleur, K. M. (1997). Synopsis
of Anatomy and Physiology, WCB McGraw-Hill, New York.
Philips, W. J., Monahan, F. D., Sand, J.K., Marek, J.F., &
Neighbors, M.(2003). Medical Surgical Nursing: Health and
Illness Perspectives, 7th Ed., Mosby, London.
Lemone, P. &Burke, K. M. (1996). Medical Surgical Nursing:
Critical Thinking in Clients Care. Addison Wesley, Menlo
Park.
Mercks Medical Manual, 2002.
Vander, A., Sherman, J., & Luciano, D. (1998).Human
Physiology: The mechanisms of body function, 7th Ed., WBC
McGraw-Hill, New York.
Dr. Kwadwo Ameyaw Korsah, UG, SON

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