(^356) Medical-Surgical Nursing Demystified
- Oral calcium—calcium gluconate, lactate, carbonate (Os-Cal).
- Large doses of vitamin D (calciferol) to help absorption of calcium.
- Aluminum hydroxide gel (Amphogel) or aluminum carbonate gel; basic
(Basaljel) to decrease phosphate levels. - Keep tracheostomy set and injectable calcium gluconate at bedside for im-
paired respiration from swelling as well as for emergency administration
of calcium.
NURSING DIAGNOSES
- Risk for imbalanced nutrition: less than what body requires
- Ineffective health maintenance
- Impaired urinary elimination
NURSING INTERVENTION
- If the parathyroids were damaged during thyroid surgery:
- Administer calcium to maintain the serum levels in a low normal range.
- Testing should be done every 3 months.
Hyperparathyroidism
WHAT WENT WRONG?
Overactivity of the parathyroid glands caused by a tumor produces too much PTH,
resulting in hypercalcemia and hypophosphatemia. Excess calcium is reabsorbed by
the kidneys and may result in kidney stones; however, malfunction in the feedback
mechanism prevents detection of excessive calcium levels in the blood, thereby fail-
ing to adjust the secretion of PTH. Parathyroid tumors are usually benign.PROGNOSIS
Patients can expect a normal life span once the parathyroid tumor is removed.14