Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 8 Endocrine System^357


HALLMARK SIGNS AND SYMPTOMS



  • Asymptomatic

  • Increased serum calcium level

  • Bone pain or fracture as a result of excreting calcium from bone

  • Kidney stones

  • Frequent urination as a result of increased calcium in the urine (hypercalciuria)


INTERPRETING TEST RESULTS



  • Increased serum calcium.

  • Increased serum PTH.

  • Decreased serum phosphate.

  • Increased urine calcium.

  • Presence of parathyroid tumor shows on ultrasound.

  • Fine needle biopsy of the parathyroid tumor.


TREATMENT



  • Surgical removal of the parathyroid tumor.

  • Administer bisphosphonates to lower serum calcium by increasing calcium
    absorption in the bone.

  • IV normal saline to dilute serum calcium.

  • Diuretic such as furosemide to excrete excess calcium in the urine.


NURSING DIAGNOSES



  • Impaired urinary elimination

  • Activity intolerance

  • Fatigue related to sleep deprivation


NURSING INTERVENTION



  • Monitor intake and output.

  • Monitor for fluid overload.

  • Monitor electrolyte balance.

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