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21 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What does parathyroid hormone does to serum levels of Ca and phosphorus?
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Increase Calcium
Decreases Phosphorus |
Will respond to low calcium an hi phosphorus
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what happens when excess there is EXCESS PTH circulating in blood?
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Bone damage
Hypercalcemia Kidney Damage |
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Pathophysiology of Hyperparathyroidsm
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1. Excessive PTH stimulates transport of calcium into the blood from
- kidney's - Intestines - bone 2. Nephrolitiasis - kidney stone which may cause pyelonephritis 3. Myopathy 4. Hypercalcemia stimulates hyprgastrinemia |
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Hyprgasterinemia can be caused due to HYpercalcemia - T/F
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True - hypergastrinemia can caused by high calcium.
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High calcium can cause what GI problems?
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- abdominal pain
- PUD - Pancreatitis |
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parathyroid hormone responds to what?
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High phosphorus
LOw calcium (when phosphorus is high, calcium is excreted) |
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what causes secondary hyperparathyroidsm
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chronic renal failure and hyperphospatemia
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Clinical manifestations of HYPer parathyroidsm
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- could be asymptomatic
- Bones, Stones - Moans - Groans depression calcification in eyes peptic ulcer or gi bleeding |
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Diagnostics of Hyperparathyroidsm
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labs and xrays
- high calcium levels - low phosphate levels - high levels of urine phos levels - high alk. phos (liver bone problems) - deminaralization of bones, loss of lamina dura @ teeth |
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Medical management of Hyperparathyroidism
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- Hydration (NS) - inhibits reabsorption of calcium by the kidneys, increase calciuria (loop diuretic after hydration is restored)
- NO THIAZIDE diruetics since they retain calcium - low calcium low Vit D diet DRUGS - Plicamycin - gallium nitrate - phosphates - CALCITONIN (thyroid hormone) - Glucocorticoids - Etidronate (calcitonin) |
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DOC for hyperparathyroidism
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GALLIUM Nitrate - fewer side effects
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what is plicamycin used for and what should u educate the clients
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Chemo drug to reduce calcium
plicamycin effect is after 24 hours and lasts about 1-2 weeks |
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Can Glucocorticoids reduce calcium?
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YES - they decrease GI absorption of calcium (also retains Na)
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A pt . is given Etidronate ? why is the pt on that med
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it is calcitonin to decrease the release of calcium by bones
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Nursing management for hypereparathyroidism
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risk of fractures
impaired urinary elimination (encourage fluids 3000ml, UO 0.5ml/kg/hr, prevent urolithiasis (cranberry juice, prune juice) - constipation (high calcium/constipation - also true with Ca channel blockers) - Imbalanced nutrition less than body requirements |
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Surgical Management of HYPerarathyroidism
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Parathyroidectomy
Autotransplantation - calcium and vit d supplements - total recovery is good - bones heal - renal disease damage may be irreversible |
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Complications of parathyroidectomy
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- Hypocalcemia can be life threatening - edema reduces function of even the normal tissue remaining
- Respiratory distress r/t experience of surgeon adequate exploration of the neck |
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Nursing management parathyroidectomy
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monitor for
- respiratory distress - hemorrhage - hypocalcemia - obstruction - laryngeal nerve - tetany/hormone imbalance - mild tetany is expected - tingling of hands and around mouth is expected and temporary - if tingling is persistant of severe - CALCIUM GLUCONATE - prevent osteoporosis - eat foods hi in calcium, injection calcium gluconate, oral calcium, ambulation WALK, WALK walk LARYNGEOSPASMS - CALCIUM GLUCONATE |
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DECREASED NEUROMUSCULAT IRRITABILITY IS FOUND IN WHAT
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HYPER PARATHYROIDISM
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increased neuromuscular activity can lead to TETANY - T/F
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True - caused by hypoparathyroidsm
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what happens to phosphate and calcium levels in hypo parathyroidsm
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low calcium
HIgh phosphate levels |
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