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Module 4 (MedSurg 2) > Parathyroid > Flashcards

Parathyroid Flashcards

(48 cards)

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1
Q

Parathyroid Hormone regulates

A

Ca balance

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2
Q

Relationship between PTH and Phosporus

A

inverse
low = high

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3
Q

If serum Ca low

A

parathyroid high PTH level & Ca is drawn from bone & low serum Ca level

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4
Q

If serum Ca high

A

thyroid high Calcitonin which lowers serum Ca

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5
Q

The parathyroid acts up when

A

2+ glands don’t function correctly

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6
Q

Calcitonin

A

tones down Ca and returns to the bone

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7
Q

Regulation of blood Calcium

A

High serum Ca
thyroid lets out Calcitonin
buildup of bone by osteoblasts
Blood Ca decreases
-Low Ca serum
parathyroid releases PTH
BREAKDOWN BY OSTEOCLASTS
Blood Ca increases

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8
Q

Primary Hyperparathyroidism

A

Enlargement of parathyroid gland(s)
High PTH = high blood Ca

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9
Q

Secondary Hyperparathyroidism

A

Excess PTH 2nd due to low Ca level
Possible causes:
- Vit. D deficiency
- Ca not absorbed from intestines

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10
Q

Tertiary Hyperparathyroidism

A

renal failure
low ability to excrete phosphate
and low Vitamin D

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11
Q

Hyperparathyroidism Labs

A

high Ca and PTH
low Phosphate

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12
Q

Hyperparathyroidism CV

A

HTN
dysrhythmias torsades de pointes

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13
Q

Hyperparathyroidism MS

A

bone pain
fracture
muscle weakness

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14
Q

Hyperparathyroidism GI

A

anorexia
constipation
N/V
abd pain

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15
Q

Hyperparathyroidism Renal

A

polyuria
renal calculi

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16
Q

Hyperparathyroidism CNS

A

Delusion of grandeur
low DTR
paresthesia

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17
Q

Hyperparathyroidism Psycho

A

depression
psychosis
cog dysfunction

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18
Q

Hyperparathyroidism mnemonic

A

Bones
stones
abd groans
psychic moans

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19
Q

If Ca is greater than _____, hypercalcemic crisis

A

15

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20
Q

Hypercalcemic s/s

Study These Flashcards
A

“W”eakness of muscles
“E”KG changes-(shortened QT interval & prolonged PR interval)
“A”bsent reflexes, “a”bsent minded (disoriented), “a”bdominal distention from constipation
“K”idney stone formation

21
Q

Mild Hyperparathyroidism mgmt

Study These Flashcards
A

high fluid and wt bearing exercise
avoid Ca supplements AND large doses Vit A and D

22
Q

Acute/Severe Hyperparathyroidism

Study These Flashcards
A

NS gtt, loop diuretics, phosphates, Calcitonin
Dialysis (greater then 15)
Surgery (not unless stabilized)
-irrigate and excrete Ca-

23
Q

Hyperparathyroidism NURSING PROBLEMS and risks

Study These Flashcards
A

Pain (bone), OTC analgesics
Knowledge deficit (why, when
Risk – Injury, Mobility
Risk – Cardiac, Neurological confusion
Risk – urinary or bowel elimination, kidney stones, contipation
Risk – fluid & electrolyte

24
Q

Hyperparathyroidism needs

Study These Flashcards
A

2-3 L of water a day with high fiber diet

25
Hyperparathyroidism Tx
Monitor if not symptomatic Ca intake 1000mg/day Vit. D 400-600 IU/day Biphosphonates – ibandronate & risedronate Calcitonin Surgery
26
Biphosphonates – ibandronate & risedronate goal
osteoporosis 2nd to hyperparathyroid
27
Biphosphonates – ibandronate & risedronate adverse effects
GI upset, musculoskeletal pain
28
Biphosphonates – ibandronate & risedronate cautions
pt with upper GI disorders, pt who cannot sit/stand upright for 30 min. (irritating if GERD)
29
Biphosphonates – ibandronate & risedronate not if
caffeine OJ
30
Biphosphonates – ibandronate & risedronate teachings
Monitor serum Ca, Phos, PTH & bone density Take in AM Remain upright for 30 min. Do not take with Ca supplements, antacids, caffeine or OJ Call if difficulty swallowing or develop heartburn – esophageal irritation
31
Calcitonin used for
hypercalcemia
32
Calcitonin goal
increases deposit of Ca and Phosphate in bone lowers Ca levels in blood
33
Calcitonin adverse effects
nausea nasal dryness
34
Calcitonin caution
allergy to fish protein, renal diseases
35
Calcitonin route
nasal spray IM SC
36
Calcitonin TEACHINGS
Nasal spray – alternate nostrils Injection – rotate sites Monitor – serum Ca, bone density Diet: high Ca & Vit. D**
37
Parathyroidectomy Pre-op
Monitor electrolytes--Ca, Phos, Mg See thyroidectomy notes
38
Parathyroidectomy Post-op
See thyroidectomy notes Monitor electrolytes Monitor for tingling in extremities or face Monitor voice pattern & quality
39
Hypoparathyroidism
deficency of PTH and low Ca
40
Hypoparathyroidism Causes
Acquired - Damage/removal Hereditary – not present or poor function Radiation – external or RAI Autoimmune – not Hashimoto’s
41
Hypoparathyroidism monitor
Mg levels
42
Hypoparathyroidism Assessments
CV:  BP, dysrhythmias** Resp: **bronchospasm**, laryngeal spasm, hoarseness GI: N/V, diarrhea, abd pain, diff. swallowing CNS: paresthesia, anxious, irritable MS: muscle cramps**, seizure, + Trousseau / Chvostek ** Lab:  PTH & serum Ca and Mg, high serum Phos
43
Bronchospasms
loud and harsh coughs difficult to tx and needs to be quick
44
s/s of hypocalcemia
Confusion Reflexes hyperactive Arrhythmias Muscle spasms Positive Trousseau’s Signs of Chvostek’s
45
Hypoparathyroidism mgmt
Goal: high serum Ca to 9 – 10 mg/dL Immediate treatment: **Calcium gluconate IV then Ca carbonate** Vitamin D Quiet environment
46
Hypoparathyroidism mgmt
Imbalance – electrolyte, nutrition Knowledge deficit Anxiety Risk - airway clearance, breathing pattern Risk – dysrhythmia Risk – injury
47
Foods high in Ca
milk, cheese, avocados, turnips, collared greens, almonds, and peanuts, soy products, dark greeny Not spinach
48
Hypoparathyroidism teachings
Monitor serum Ca & Phos. Prevent constipation Nutrition – high Ca & low Phos. IV calcium – telemetry monitoring

Module 4 (MedSurg 2) (36 decks)

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