INTERVENTION

Monitor VS (BP). Hypertension may occur. Monitor for urine output. Polyuria causes Dehydration

Alternative Name: Parathyroid-related hypercalcemia A condition in which the parathyroid glands, located in the neck, secrete too much parathyroid hormone (PTH). Usually due to a benign growth of 1:4 parathyroid glands.

Increased fluid intake. To prevent dehydration and renal stone formation. Administer normal saline IV as prescribed to maintain hydration. Sodium enhances excretion of calcium. Severe in diet. Decreased Calcium & increased phosphorus symptoms of hypercalcemia. Move client slowly and carefully. Client may experience skeletal pain and they are at risk for fracture. PARATHYROID CRISIS phosphorous level. Monitor calcium and Teach signs Calcium Inc. blood PTH & of: (+) vomiting (+) diarrhea Fluid & electrolytes imbalance. Removal of one or more of the parathyroid glands. Monitor for hypocalcemic crisis!.

TYPES OF HYPERPARATHYROIDISM
PRIMARY: result from a hyperfunction of the parathyroid glands. SECONDARY: Due to excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia(low blood calcium levels) and/or hyperphosphatemia (high blood phosphate levels), usually due to chronic renal failure. TERTIARY: Caused by long lasting disorders of the calcium feedback control

REMEMBER: Hyperthyroidis m is a Hormone Problem and not a Cancer Problem

CAUSES
Parathyroid gland NORMAL ABNORMAL Benign tumors in the parathyroid glands Parathyroid hyperplasia (excessive growth of normal parathyroid cells) Parathyroid cancer (rare) Certain endocrine disorders, such as Type I and II multiple endocrine

PHARMACOLOGY EVALUATION
Skin turgor is good. Client states relief from abdominal discomfort. Maintained fluid and electrolyte balance&

Administer Lasix (Furosemide) to lower serum calcium levels. Administer calcitonin. To decrease skeletal calcium release and increase renal clearance. Avoiding thiazide-type diuretics ("water pills").

Parathyroid adenoma PTH

COMPLICATION
Skeletal damage Hypertension Osteoporosis Peptic ulcers Pseudogout Kidney stones

(SHOPP-Kid)

PLANNING
To prevent other complications. Relief from abdominal discomfort.

CALCIMIMETICS It is recognised by the body as if it is calcium, in other

DIAGNOSTIC FINDINGS

BONE DECALCIFICATION

SIGNS & SYMPTOMS

Feeling of weakness or fatigue R: because of overwork of muscle.

Serum calcium is increased.

CALCIUM IN THE BONE CALCIUM IN THE BLOOD INCREASED calcium will cause Slowed impulse transmission Dec. GI motility. Calcification of arterial wall. Increase acid

Confusion, poor memory R: dec. level of calcium in the bone will slow the transmission of impulse in your brain. Thinning bones R: because of too much lose of calcium in the bones. High Blood Pressure R: due to calcification of the arterial wall that cause over contraction of the heart. Increased thirst and urination R: your kidney will sense a high concentration of your body will increase urination to excrete this too much calcium R: increase urination will decrease fluid volume, it will triggers thirst mechanism. calcium in the blood, as compensation

Serum phosphorus may be decreased. Qualitative Urinary Calcium (Sulkowith Test) (+) or Increase precipitate.

Parathormone Radioimmunoassay Increase, the most specific test for hyperparathyroidism.

NURSING DIAGNOSIS

Anxiety r/t change in health status in associated changes in role function as

manifested by confusion, increased urination and nausea.

Fluid
Pepper and Salt appearance

volume deficit r/t active fluid loss through increased dieresis as manifested by thirst.

Nausea, vomiting or loss of appetite R: due to increase gastric acid that will trigger the

Risk for trauma r/t inc. risk of fracture. Impaired physical mobility r/t musculoskeletal impairments as manifested