2. The parathyroid glands release a chemical
(hormone) called parathyroid hormone. This
hormone helps to control the levels of two salts in
the body, calcium and phosphorus.
There are four parathyroid glands, each the size of
a grain of rice, in your neck behind the thyroid
gland, They produce parathyroid hormone (PTH)
which helps control the levels
of calcium, phosphorus and vitamin D within the
bones and blood.
Normal level of serum Calcium is:- (9-10.5 mg/dl)
Normal level of phosphorous is 2.5-4.5 mg/dl
Introduction:-
3. “”It occur due to hypo-secretion of PTH
By parathyroid gland Characterized by
decrease calcium level & Hyperphosphetemia””
Definition:-
4. 1. Acquired hypoparathyroidism (Acquired hypothyroidism is a
condition that develops when your child's thyroid gland makes little
or no thyroid hormone. Thyroid hormones help control body
temperature, heart rate, and how your child gains or loses
weight. Thyroid hormones play an important role in normal growth
and development of children.)
2. Transient hypoparathyroidism (occurs most commonly in babies who
are born too soon (prematurely)
3. Congenital hypoparathyroidism or DiGeorge's
syndrome (The parathyroid glands do not develop properly while the baby is
growing in the womb)
4. Inherited hypoparathyroidism (caused by an inherited problem
caused by chemicals called antibodies attacking the parathyroid gland. This is
called an autoimmune illness)
Types/Classification:-
5. Tumor of thyroid gland
It can occur following thyroidectomy because
of removal of parathyroid tissue.
Accidental removal of parathyroid gland.
Idiopathic causes
Inadequate secretion of PTH.
Increased re-absorption of calcium in GI tract.
Phosphate excretion by the kidney-decreases.
Etiology:-
6. Due to the etiological causes
Decrease in gland Function
Resistance to PTH action
Inadequate PTH secretion and Increased re-absoption of
Ca in GI tract
Blood Calcium fall to low level
Muscular hyper irritability
Uncontrolled spasm, Hypo calcemic Tetany.
PATHOPHYSIOLOGY:-
7. Hypocalcemia & hyperphasphatemia
Dry hair, rough pale skin Hair loss
Cold intolerance (you can't tolerate cold
Due to hypocalcemia there is sign of Tetany:-
◦ Carpopedal spasm
◦ Bronchospasm
◦ Laryngospasm
◦ Visual disturbance
◦ Seizures
Numbness & tingling in the face
Muscle cramps & cramps in the abdomen & or
in the extremities
C/M:-
9. Positive Trousseau’s sign ( When we inflate
the BP cuff on arm (Inflate above systolic)
then there is spasm/contraction of finger of
that arm.
10. Positive Chevostek sign:-Contraction of
facial muscle when light tapping of facial
nerve in front of the ear.
11. History collection
Lab studies
Physical Examination
To check PTH Level
Diagnostic Evaluation:-
12. Monitor vital sign
Administer Calcium gluconate or calcium chloride for
hypocalcaemia (IV).
If calcium gluconate does not decreases
neuromuscular irritability administer sedative-
Pentobarbital.
Vit. D (To enhances the absorption of cal from GI tract)
Administer Phosphate binder (to promote excretion of phosphate
from GI tract)
Parental Parathrompine can be administered to treat
acute hypothyroidism
Aluminium hydroxide (Gelusil) is administered after
meal to bind phasphate and to promote excretion of
phosphate from GI tract
Medical Management:-
13. S/M:-
Tracheotomy or Mechanical ventilation may
become necessary, along with Broncho dilating
medication if patient develops respiratory
distress.
Hormonal replacement therapy
Advice:-
Diet:-High cal ,Vit D, Low phosphate
Instruct the client to wear a medic-alert bracelet
Surgical Management :-
14. Acute airway obstruction
CV Failure
Mental Disorder
Sub capsular cataract
Shortening of fingers and toes
Below normal temperature
Decreased breathing
Low blood pressure
Low blood sugar
Unresponsiveness
Complication:-
15. Activity Intolerance related to weakness and
apathy.
Less than body requirement (calcium level) r/t
inadequate calcium diet or intake.
Risk for ineffective airway clearance related to
laryngospasm.
Nursing Diagnosis:-
