240 likes | 416 Vues
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.
E N D
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 • 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 • Why do we need it? • Bones • Teeth • Blood coagulation • Transmission of nerve impulses • Muscle contraction & relaxation • Normal heartbeat
Hyperparathyroidism • Pathophysiology • h Parathyroid activity • h PTH • (What does PTH do?????) • h blood Ca levels (out of control) • Hypercalcemia
Hyperparathyroidism • Where is the Ca coming from? • Movement of Ca out of the bones blood
Hyperparathyroidism • Etiology • Hyperplasia/ tumor of parathyroid gland • Heredity
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
Hyperparathyroidism • Diagnostic tests • h serum Ca levels • X-ray
Hyperparathyroidism • Medical management • Goal = i PTH • h fluids
Hyperparathyroidism • Pharmaceutical interventions • Lasix (Furosemide) • h renal secretion of Ca • Pamidronate (Aredia) • Calcitonin • Prevents Ca release from bones
Hyperparathyroidism • Surgical management • If sever remove • Remove 3 ½ glands • Post OP • Bone pain gone in 3 days • Renal damage permanent
HYPOparathyroidism • Pathophysiology • i PTH • i blood reabsorption of Ca from bone • i serum Ca levels • Hypocalcemia
Hypoparathyroidism • Etiology • Heredity • Thyroidectomy (accidental removal)
Hypoparathyroidism • S&S • Hypocalcemia causes neuromuscular irritability
Hypoparathyroidism • S&S: Acute • Tetany • Tingling of fingers • Muscle spasms • Twitching • + Chvostek’s sign • + Trousseau’s sign
Hypoparathyroidism • Chvostek’s sign • Tap facial nerve • Facial spasm
Hypoparathyroidism • + Trousseau’s sign • Occlusion of brachial artery > 3 min. • Carpal spasm
Hypoparathyroidism • Chronic S&S • Lethargy • Muscle spasms • Calcification in eyes or brain • Convulsions • Laryngospasms • obstruction of larynx • deathmosis
Hypoparathyroidism • Diagnostic tests • Chvostek’s sign • Trousseau’s sign • i serum Ca levels • i PTH levels
Hypoparathyroidism • Medical management • IV Ca Glugonate • Breath into bag • Acidosis • In Ca levels • In Ca diet • Oral Ca • Vitamin D • Thiazide diuretics
Hypoparathyroidism • Nursing Management • p For S&S tetany • p Stridor