parathyroid glands control what?
the amount of calcium in our blood and bones
hypoparathyroidism
body is producing low levels of parathyroid hormone
-resulting in a drop in blood calcium levels
S/S of hypoparathyroid
tingling, numbness, spasms of the larynx/bronchospasm ,etc.
tentany
serious sign resulting from low serum calcium levels
S/S of tentany
numbness/tingling, cardiac arrhythmia's, seizures
chvosteks sign
(signs of hypocalcemia)
muscle irritability when the facial nerve is gently tapped
-nerve is located in front and just below the ear
(twitching facial muscle occurs)
trousseaus sign
(occurs with hypocalcemia)
a positive trousseaus sign will present as a carpool spasm
diagnosis for hypoparathyroidism
clinical s/s , lab tests, EKG, CT scan, bone scans
treatment for hypoparathyroidism
iV calcium gluconate to raise serum calcium levels to normal range.
-chronic PTH replacement therapy
hyperparathyroidism
parathyroid gland produces to much PTH, which causes serum calcium levels to rise
-elevated calcium and decrease phosphate.
S/S of hyperparathyroidism
can be mild or severe and can also be asymptomatic
-confusion -skeletal changes/ osteoporosis (thinning of bones)
to much hyperparathyroidism in the blood, causes the bones to lack calcium
(T/F)
true
adequate hydration for hyperparathyroidism is a prevention for what?
kidney stones
diagnosis for hyperparathyroidism
- labs- magnesium, vitamin d, serum albumin levels
- bone scans
treatment for hyperparathyroid
isotonic IV fluids and loop diuretics (ex: lasix/ furosemide)
for hyperparathyroidism what do you want to monitor?
daily weights and I&O, serum electrolytes
Adrenal Glands
sit on top of each kidney
-composed of two parts; adrenal cortex and adrenal medulla
adrenal cortex
secretes corticosteroids
mineralcorticosterioids (aldosterone)
sodium and water balance
glucocortisteroids (cortisol)
counteracts inflammatory response, stress response, needed for utilization of carbs, proteins, and fats
adrenal gland disorder
pohechromocytoma
-rare tumor of the adrenal medulla
-causes severe hypertension
adrenal gland disorder S/S
FIVE H's
- Hypertension
- headache
- hyperhidrosis (excessive sweating)
- hypermetabolism
- hyperglycemia
- severe hypertension (250/150)
adrenal gland disorder diagnosis and treatment
diagnosis: 24 hour urine
treatment: adrenalectomy (surgical removal)
Addisons disease
decreased function of the adrenal cortex
Addisons disease s/s
mild symptoms and not always reported or just vague.
- fluid electrolyte imbalances
- hypoglycemia
- EVERYTHING'S LOW.
Addisons disease treatment
hormone replacement therapy
(LIFELONG THERAPY)
- presiosne- replace glucocorsteroids
- fludrocortisone to replace mineralocorticoids
adrenal crisis/ Addison crisis
and s/s
potentially fatal crisis
S/S- weight gain -buffalo hump -moon face -amenorrhea -very hard for wounds to heal due high blood sugar
adrenal crisis/ Addison crisis diagnosis and treatment
- labs (dexamethasone, suppression test
- treatment- pituitary gland surgery
hyperparathyroid
remember to worry about bones and kidney stones
pheochromacytama reports?
headache and sweating and palpitations
-monitor blood pressure closely
Addisons disease think
hyperkalemia
with Addisons disease your patient would be
hypotensive, confused& tachycardic
-priority= give fluids & hydrocortisone
patient is crushings is high risk for ?
infection
hypocalcemia S/S
tetany, muscle twitching, bronchospasm
Addisons findings
bronze skin, hypotension, hyponatremia, and hyperkalemia
cushings syndrome is at risk for what ?
infection, hypokalemia, osteoporosis, hypertension, and hyperglycemia
what is most likely the cause of death in a patient with acute hypoparathyroidism ?
bronchospasms or laryngospasm
what condition can trousseaus sign indicate ?
hypocalcemia
what dietary recommendation is important for patients with chronic hypoparathyroidism?
consume foods high in calcium but low in phosphorus
how can bone demineralization in hyperparathyroidism patients be stabilized?
ambulating
what is a common finding in bone scans for patients with hyperparathyroidism?
osteoporosis/ osteopenia
which hormone is responsible for maintaining sodium and water balance in the body?
aldosterone
what is the primary function of cortisol?
counteract inflammatory response and stress response
a patient is admitted after thyroidectomy and reports tingling in the lips and fingers, the nurse notes chvosteks sign, what is the priority intervention ?
administer iv calcium gluconate
which statement by the patient with chronic hypoparathyroidism indicates correct understanding of the diet?
I should eat green leafy vegetables
a patient with hyperparathyroidism is at risk for which complication?
kidney stones
hyper=
high calcium, bones and stones
hypo=
tetany
a patient with hyperparathyroidism has a calcium level of 13.5 , what is the nurses priority action ?
administer iv fluids
a patient with pheochromocytoma reports headache, sweating and palpitations, what is the priority nursing action?
monitor blood pressure closely
which lab finding is expected with Addisons disease?
hyperkalemia
a patient with Addisons disease becomes hypotensive, confused, and tachycardic. what is the priority intervention ?
give IV fluids and hydrocortisone
what is happening? Addisons crisis, patient will drop blood pressure and become confused.
NEEDS STEROIDS
Which assessment finding is most characteristic of Cushings ?
moon face, wound healing
bronze skin, weight loss, hypotension =
Addisons disease
a patient with cushings is at risk for ?
infection (high blood sugar)
which are signs of hypocalcemia ?
bronchospasm, muscle twitching, and tetany
which findings are expected in Addisons disease?
hypotension, bronze skin, hyponatermia, hyperkalemia
a patient with bp of 210/110 and headache, palpations, diaphoresis. what condition should the nurse suspect?
pheochromocytoma
a patient with cushings is at risk for which complication?
infection, hyperglycemia, hypokalemia, osteoporosis, and hypertension