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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
slide10
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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