Hypoparathyroidism

Ratheesh.R

1. Ratheesh.R SLMGNC Hypoparathyroidism Or Tetany

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

3. “”It occur due to hypo-secretion of PTH By parathyroid gland Characterized by decrease calcium level & Hyperphosphetemia ””

4. 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.) Transient hypoparathyroidism (occurs most commonly in babies who are born too soon (prematurely) Congenital hypoparathyroidism or DiGeorge's syndrome (The parathyroid glands do not develop properly while the baby is growing in the womb) Inherited hypoparathyroidism (caused by an inherited problem caused by chemicals called antibodies attacking the parathyroid gland. This is called an autoimmune illness)

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.

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

8. Dysphagia Photophobia Cardiac dysrhythmias Convulsion Cont….

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

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:-