This is an NCLEX review for hypoparathyroidism vs hyperparathyroidism. Patients who have parathyroidism suffer with either high or low levels of parathyroid hormone (PTH). The parathyroid hormone is responsible for regulating calcium levels in the blood. PTH does this by causing the bones to release calcium, and also influences the kidneys to conserve calcium. Therefore, if the PTH levels are too high or too low, calcium levels will be affected which will cause specific signs and symptoms.
Don’t forget to take quiz hypoparathyroidism vs hyperparathyroidism.
As the nurse, it is important you know the differences between hypo and hyperparathyroidism. In this review you will learn the following:
- Definition of hypoparathyroidism vs hyperparathyroidism
- Causes of hypoparathyroidism vs hyperparathyroidism
- Signs and Symptoms of hypoparathyroidism vs hyperparathyroidism
- Nursing Interventions of hypoparathyroidism vs hyperparathyroidism
- Treatments for hypoparathyroidism vs hyperparathyroidism
Lecture on Hypoparathyroidism and Hyperparathyroidism
Hypoparathyroidism and Hyperparathyroidism Nursing
Hypoparathyroidism
Definition: low secretion of parathyroid hormone by the parathyroid gland
Presents with HYPOcalcemia and HYPERphosphatemia (due to the role of PTH on the bones and kidneys…PTH is unable to stimulate them to increase calcium levels in the blood)
Causes of Hypoparathyroidism
- Damage or manipulation of the thyroid or parathyroid gland (thyroidectomy)
- Low magnesium level (hypomagnesemia): parathyroid gland doesn’t function properly if there are low magnesium levels
- Autoimmune: body attacks the gland
- Body resistant: parathyroid gland working great but the bones and kidneys not receptive to PTH
Signs & Symptoms of Hypoparathyroidism
Mainly due to hypocalcemia..remember PTH
- Parathesia, Positive Trousseau and Chvostek’s Sign
- Tetany (involuntary muscle cramping/contraction)
- Hypocalcemia and Hyperphosphatemia
Nursing Interventions for Hypoparathyroidism
- Monitor VS, airway, labs, educate diet (high calcium, low phosphate)
- Administer Medications: Goal of medications are to increase calcium levels and decrease phosphate levels
- IV calcium (if severe) Calcium Gluconate
- Oral calcium supplements with vitamin D (side effects: GI upset, constipation, increase risk of renal stones)
- Phosphate-binders: Aluminum carbonate to remove phosphate into stool (take after meal)
- Parathyroid replacement: Natpara (injection)…watch calcium levels, GI upset, or parathesia
Hyperparathyroidism
Definition: high secretion of parathyroid hormone by the parathyroid gland
Presents with HYPERcalcemia and HYPOphosphatemia (due to the role of PTH on the bones and kidneys…overstimulates them to increase calcium levels in the blood)
Causes of Hyperparathyroidism
- Primary: something is wrong with the parathyroid gland itself
- Hyperplasia (enlarged), adenoma, cancerous tumor
- Secondary: disease is causing the parathyroid gland to not work properly
- Hypocalcemia, Vitamin-D deficiency…main cause is Chronic Renal Failure (remember kidneys play a huge role in increasing calcium levels and activating vitamin-d….the parathyroid becomes overworked)
Signs & Symptoms of Hyperparathyroidism
Mainly due to hypercalcemia
- Bone fractures (bones become depleted of calcium)
- Constipation (GI system slows down …remember calcium plays a role in muscle contraction)
- Renal calculi formation (concentrated amounts of calcium in the blood)
- Nausea and vomiting with epigastric pain
Nursing Interventions for Hyperparathyroidisim
- Monitor VS, urine for kidney stones, encourage fluids to prevent dehydration and stone formation, monitor labs, educate on diet (low calcium, high phosphate…but watch phosphate in renal patients)
- Prep for Parathyroidectomy: treatment in primary hyperparathyroidism
- Administered Medications: goal decrease calcium levels and keep hydrated
- IV solutions: normal saline for hydration
- Calcimimetics: “Senispar” decreases PTH, calcium, and phosphate levels (treatment for secondary hyperparathyroidism for patients with chronic kidney disease)
- Calcitonin: lowers calcium levels and protects bones
- Lasix: loop diuretics decrease calcium levels by inhibiting calcium resorption in the renal tubules (watch potassium levels because Lasix wastes potassium)
- Bisphosphonates: Pamidronate (Aredia) or Alendronate (Fosamax) helps protect bones from losing calcium by slowing down osteoclasts (which break down bones) and allow osteoblasts to work (to help build bones)
You may be interested in more NCLEX Reviews.
References:
- “How Is Hypoparathyroidism Treated?”. Nichd.nih.gov. Web.
- “Hypercalcemia – National Library Of Medicine – Pubmed Health”. PubMed Health. Web. 7 Aug. 2016.
- “Primary Hyperparathyroidism | NIDDK”. National Institute of Diabetes and Digestive and Kidney Diseases. N.p., 2012. Web. 8 Aug. 2016.