Endocrine parathyroid
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Endocrine - Parathyroid. Part 1. Parathyroid - description. 4 Parathyroid glands Behind thyroid (lobe). Parathyroid - function. PTH  h blood Ca levels PTH stimulated by hypocalcemia PTH is inhibited by hypercalcemia. PTH - function.

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Parathyroid description
Parathyroid - description

  • 4 Parathyroid glands

  • Behind thyroid (lobe)


Parathyroid function
Parathyroid - function

  • PTH  h blood Ca levels

  • PTH stimulated by hypocalcemia

  • PTH is inhibited by hypercalcemia


Pth function
PTH - function

  • h the reabsorption of Ca & P from bone  blood

  • h absorption by sm. Intestine

  • h reabsorption by kidney

  • Increases blood Ca levels

  • Antagonist to Calcitonin

  • It is the most important regulator of serum Ca levels.


Calcium
Calcium

  • Why do we need it?

    • Bones

    • Teeth

    • Blood coagulation

    • Transmission of nerve impulses

    • Muscle contraction & relaxation

    • Normal heartbeat


Hyperparathyroidism
Hyperparathyroidism

  • Pathophysiology

    • h Parathyroid activity 

    • h PTH 

    • (What does PTH do?????)

    • h blood Ca levels  (out of control)

    • Hypercalcemia


Hyperparathyroidism1
Hyperparathyroidism

  • Where is the Ca coming from?

  • Movement of Ca out of the bones  blood


Hyperparathyroidism2
Hyperparathyroidism

  • Etiology

    • Hyperplasia/ tumor of parathyroid gland

    • Heredity


Hyperparathyroidism3
Hyperparathyroidism

  • S&S

    • d/t h serum Ca levels

    • Fatigue/

    • Depression

    • Confusion

    • Polyuria

    • N/V  anorexia

    • Kidney stones

      • Renal calculi


  • S&S

    • Cardiac dysrhythmias

    • Peptic ulcers

    • Pathological fractures

      • Back pain

      • Bone tenderness

    • Coma

    • Cardiac arrest


Hyperparathyroidism4
Hyperparathyroidism

  • Diagnostic tests

    • h serum Ca levels

    • X-ray


Hyperparathyroidism5
Hyperparathyroidism

  • Medical management

    • Goal = i PTH

    • h fluids


Hyperparathyroidism6
Hyperparathyroidism

  • Pharmaceutical interventions

    • Lasix (Furosemide)

      • h renal secretion of Ca

    • Pamidronate (Aredia)

      • Calcitonin

      • Prevents Ca release from bones


Hyperparathyroidism7
Hyperparathyroidism

  • Surgical management

    • If sever  remove

    • Remove 3 ½ glands

    • Post OP

      • Bone pain gone in 3 days

      • Renal damage permanent


Hypoparathyroidism
HYPOparathyroidism

  • Pathophysiology

    • i PTH 

    • i blood reabsorption of Ca from bone 

    • i serum Ca levels 

    • Hypocalcemia


Hypoparathyroidism1
Hypoparathyroidism

  • Etiology

    • Heredity

    • Thyroidectomy (accidental removal)


Hypoparathyroidism2
Hypoparathyroidism

  • S&S

    • Hypocalcemia causes neuromuscular irritability


Hypoparathyroidism3
Hypoparathyroidism

  • S&S: Acute

    • Tetany

    • Tingling of fingers

    • Muscle spasms

    • Twitching

    • + Chvostek’s sign

    • + Trousseau’s sign


Hypoparathyroidism4
Hypoparathyroidism

  • Chvostek’s sign

    • Tap facial nerve 

    • Facial spasm


Hypoparathyroidism5
Hypoparathyroidism

  • + Trousseau’s sign

    • Occlusion of brachial artery > 3 min.

    • Carpal spasm


Hypoparathyroidism6
Hypoparathyroidism

  • Chronic S&S

    • Lethargy

    • Muscle spasms

    • Calcification in eyes or brain

    • Convulsions

    • Laryngospasms

      •  obstruction of larynx

      •  deathmosis


Hypoparathyroidism7
Hypoparathyroidism

  • Diagnostic tests

    • Chvostek’s sign

    • Trousseau’s sign

    • i serum Ca levels

    • i PTH levels


Hypoparathyroidism8
Hypoparathyroidism

  • Medical management

    • IV Ca Glugonate

    • Breath into bag 

      • Acidosis

      • In Ca levels

    • In Ca diet

    • Oral Ca

    • Vitamin D

    • Thiazide diuretics


Hypoparathyroidism9
Hypoparathyroidism

  • Nursing Management

    • p For S&S tetany

    • p Stridor


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