Parathyroid

Question 1

Where are the parathyroid glands and what do they secrete?

Answer 1

Four Glands on back surface of thyroid gland

Secrete Parathyroid hormone (PTH)

Question 2

what does PTH do?

Answer 2

• Acts on bones, kidneys and GI tract
• Regulates calcium and phosphorus metabolism by
◦ Increasing bone resorption (Increases serum calcium)
◦ Activating Vitamin D (Increased Ca and Phosphate absorption in intestines)
◦ Allowing kidney reabsorption in kidneys (increased serum calcium)

Question 3

what determines PTH secretion? how does the mechanism work?

Answer 3

• Calcium levels in blood determine PTH secretion

◦ Less PTH secreted from Parathyroid glands when Ca levels are high– slows down leaching of calcium from bones

◦ More PTH secreted from Parathyroid glands when Ca levels are low

Question 4

When Ca levels are PTH levels….

Answer 4

go low (to decrease leaching of Ca from bones)

Question 5

When Ca levels are low, PTH levels….

Answer 5

increase! to increase Ca level

Question 6

what is the patho of hyperparathyroidism?

Answer 6

• Excessive production/ secretion of parathyroid hormone
• Increased bone resorption (Increased Ca and Phosphorus in blood)
• ↑ Levels of Ca and Phosphorus in blood and tissues
• ↓ Levels of Ca and Phosphorus in bones –>↓ bone density

Question 7

Causes of Hyperparathyroidism?

Answer 7

• Tumor
• Neck Trauma
• Low Levels of Vitamin D
• Kidney Disease
• Lung, Kidney or GI tract carcinomas (PTH Production)

Question 8

Hyperparathyroidism Assessment

Answer 8

◦ result of increase in calcium 
• Bone fractures/ deformities
• Arthritis
• Stress
• Waxy pallor
• Kidney stones
• Bone lesions
• GI issues
• PUD
• Anorexia
• Weight Loss
• Nausea/ vomiting
• Constipation
• Lethargy
• Psychosis
• Coma

Question 9

Hypercalcemia Assessment

Answer 9

• BONES (Painful bone conditions)
• STONES (Kidney stones)
• GROANS (GI symptoms)
• MOANS (Mental/ CNS)
• Weakness, Cardiac issues

Question 10

diagnostics for hyperparathyroidism

Answer 10

*Serum PTH
*Serum Calcium
*Serum Phosphorus
X-rays

look at underlying causes:
Arteriogram
CT Scan
Ultrasound

Question 11

interventions for hyperparathyroid?

Answer 11

• Surgery- remove PTH gland
• Diuretics- increase Ca excretion
◦ Hydration back it up b/c they don’t really need to lose a lot of fluid
• Monitor Cardiac Function
• Intake and output
• Injury Prevention due to pathological fractures and risk w/ falls : slide sheet/ transfer devices
• Drink 3-4 liters water per day

Question 12

how much water do you want to drink for hyperparathyroidism?

Answer 12

3-4 L / day

Question 13

get ____ levels in a good place prior to surgery for PTH and TH removal!

Answer 13

Calcium

Question 14

post thyroidectomy care

Answer 14

• Similar to care post thyroidectomy
• Monitor for tingling / twitching of face and extremities
• Trousseau’s - spasm of hand when blood cuff is inflated (2 minutes later)= sign of HYPOcalcemia
• Chvostek’s signs- tap side of face twitching nerve = sign of HYPOcalcemia
• Changes in voice/ hoarseness

Question 15

what happens if you take some of the parathyroid gland but not all? what happens if you take it all?

Answer 15

• If all four are removed, part of one may be implanted into forearm
• When all 4 glands are removed, Calcium and Vitamin D must be supplemented for lifetime

Question 16

spasm of hand when blood cuff is inflated (2 minutes later) =

Answer 16

• Trousseau’s

Question 17

tap side of face- twitching nerve=

Answer 17

• Chvostek’s signs

Question 18

• Chvostek’s signs and Trousseau’s are signs of ….

Answer 18

HYPOcalcemia ,