Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 8 Endocrine System^355


hypoparathyroidism is destruction of the glands by an autoimmune cause. Para-
thyroidectomy is no longer a major cause, since surgery now only removes the
gland that is malfunctioning. Occasionally the gland(s) may be accidentally
removed during thyroidectomy.


PROGNOSIS


Prognosis depends on the promptness with which a diagnosis is made and treat-
ment started.


HALLMARK SIGNS AND SYMPTOMS



  • Tetany (muscle irritability) due to abnormal levels of calcium

  • Tingling of periorbital area, hands, and feet from abnormal calcium levels

  • Lethargy due to low levels of parathyroid hormone

  • Cataract development

  • Convulsions due to acute low calcium levels


INTERPRETING TEST RESULTS



  • Decreased serum calcium due to low levels of PTH.

  • Increased serum phosphate due to low levels of PTH.

  • Decreased serum PTH from diminished secretion from the parathyroid
    glands.

  • Decreased urinary calcium from diminished PTH.

  • Positive Chvostek’s sign due to decreased calcium levels.

  • Positive Trousseau’s sign due to decreased calcium levels.


TREATMENT



  • Initiate seizure precaution.

  • Administer calcium gluconate by slow IV drip for acute hypocalcemia.

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