Endocrine: Parathyroid

Front 1

Parathyroid Hormone will ___________ when calcium is low

Back 1

increase

Front 2

Parathyroid will be inhibited with ______ Ca or ______Mg

Back 2

high Ca, high Mg

Front 3

High Ca? ________ is released to lower it

Back 3

Calcetonin

Front 4

Low Ca? ________________ will be released to pull Ca from bone and increase Ca absorption in the kidney

Back 4

PTH

Front 5

Ca & ___________ are "brothers"

Back 5

Ph

Front 6

Ca and _________ are "sisters"

Back 6

MG

Front 7

PTH will: _____________ calcium absorption in the intestines

Back 7

increase

Front 8

PTH will: ____________ Ca excretion in the kidneys

Back 8

decrease

Front 9

PTH will ____________ Ca breakdown in the bone (PTH PULLS)

Back 9

increase

Front 10

High Ca stimulates _______________ from thyroid

Back 10

Calcitonin

Front 11

Calcitonin ___________ calcium in the bone. PTH __________calcium from the bone.

Back 11

Calcitonin keeps, PTH pulls

Front 12

Calcitonin causes kidneys to ______________ calcium

Back 12

excrete

Front 13

Serum Ph is _______________ to calcium

Back 13

inverse

Front 14

3 diagnostic studies for Parathyroid

Back 14

PTH, Serum Ca, Serum pH

Front 15

Hyperparathyroidism: describe

Back 15

Elevated PTH causes elevated blood calcium.

Front 16

Sx of Hyperparathyroidism

Back 16

are sx of high Ca: weakness, loss of appetite, constipation, increases need for sleep, emotional disorder, short attention span

Front 17

3 Major Signs of Hyperparathyroidism

Back 17

fractures, kidney stones, neuromuscular muscle weakness

Front 18

Ca levels in Hyperparathyroidism

Back 18

>10

Front 19

Diagnostics for Hyperparathyroidism

Back 19

PTH, Serum calcium>10, elevated urine calcium, serum Cl, uric acid, Cr, amylase (pancreas), all phosphate (bone disease). Low Ph<3mg/dl, BMD, MRI/CT/US

Front 20

Diagnostics for Hyperparathyroidism: Ph

Back 20

<3mg/dl

Front 21

normal Ph

Back 21

2.4-4.4

Front 22

normal magnesium

Back 22

1.5 to 2.5

Front 23

Diagnostics for Hyperparathyroidism: expected serum calcium

Back 23

>10

Front 24

Diagnostics for Hyperparathyroidism: 6 Elevated electrolytes

Back 24

elevated urine calcium, elevated serum Cl, uric acid, Cr, amylase, alk. phos.

Front 25

most effective surgical tx for hyperparathyroidism

Back 25

Parathyroidectomy

Front 26

what is a Parathyroidectomy

Back 26

most effective surgical tx for hyperparathyroidism, can be partial or total removal, done outpatient endoscopically

Front 27

5 criteria for Parathyroidectomy

Back 27

SERUM CA: >12mg/dl HYPERCALCIURIA: 400mg/day MARKEDLY REDUCED BMD NEUROMUSCULAR/NEPHROLITHIASIS AGE: under 50 years

Front 28

Post Parathyroidectomy watch for signs of:

Back 28

low calcium

Front 29

What are signs of low calcium

Back 29

Tetany, tingling, Trousseau's/Chvostek's sign

Front 30

4 Nursing management post parathyroidectomy

Back 30

KEEP IV CALCIUM BY THE BEDSIDE, I/O, Monitor Ca, Phosphate, Mg levels, Watch for signs of low Ca, Ambulate

Front 31

Conservative approach to hyperparathyroidism, non surgical DIET TX

Back 31

High fluid intake. Low Ca. Na 8-10g/d. Ph supplements

Front 32

Conservative approach to hyperparathyroidism, non surgical Monitoring

Back 32

Yearly serum PTH, calcium, phosphorus, alk phos. Test renal function. X-rays (assess for metabolic bone disease), measure urine calcium excretion.

Front 33

Goal of pharmacologic agents in tx hyperparathyroidism

Back 33

goal- lower Ca level

Front 34

Generic name for Fosamax

Back 34

Alendronate

Front 35

3 meds given for hyperparathyroidism

Back 35

1. Alendronate (Fosamax), 2. Phosphate, 3. Diuretics

Front 36

How does phosphate work in tx hyperparathyroidism

Back 36

stops vitamin D absorption at the intestine so calcium is not absorbed

Front 37

how do you give alendronate (Fosamax)

Back 37

take alendronate by mouth on an empty stomach in the morning at least 30 minutes before food, drink, or other medications. Swallow whole, take with a full glass of plain water. Do not lie down for 30 min after taking alendronate or prior to eating first food of the day.

Front 38

what is hypoparathyroidism

Back 38

inadequate circulating PTH causing hypocalcemia

Front 39

4 causes of hypoparathyroidism

Back 39

REMOVAL OF PARATHYROID. atrophy, antibodies, severe low MG w/ suppressed PTH.

Front 40

low calcium levels cause:

Back 40

chronic renal failure, vitamin D deficiency, hypomagnesemia, and atrophy of parathyroid gland

Front 41

nursing management tx goal for hypoparathyroidism

Back 41

tx tetany, keep normal Ca levels, prevent complications

Front 42

tx hypoparathyroidism w/

Back 42

IV Ca

Front 43

S/e of IV Calcium

Back 43

low BP, arrhythmias, arrest, vein irritation (monitor digoxin levels)

Front 44

what does a rebreathing mask do for a patient with hypoparathyroidism

Back 44

increases CO2, makes them acidotic, lowers their calcium

Front 45

Diet for patient w/ hypoparathyroidism?

Back 45

high calcium diet: dark green vegetables, soybeans, tofu.

Front 46

how often should hypoparathyroidism patients have Ca drawn

Back 46

3-4 times per year

Front 47

2 vitamins to give to hypoparathyroidism patient

Back 47

1.5-3 grams PO calcium, Vitamin D (calcitriol)

Front 48

what is Calcitriol, what does it do

Back 48

vitamin D analog, helps to absorb calcium

Front 49

Diet for patient w/ hypoparathyroidism, what foods to avoid?

Back 49

oxalic acid: spinach, rhubarb (inhibit calcium absorption)

Front 50

what will patient look like with high calcium

Back 50

lethargic, memory loss, personality changes, anorexia (n/v), bone pain, polyuria, dehydration, kidney stones, stupor/coma.

Front 51

what will a patient look like with low calcium

Back 51

fatigue, depressed, numbness/tingling, hypereflexia, cramps, Chvostek/Trousseau's sign, Laryngeal spasm, Tetany/seizures.