Hyperparahyroidsm is an endocrinal disorder majorly affecting the parathyroid glands which secrete parathyroid hormone and calcitonin.
A condition characterised by excessive secretion of calcium in blood and Bone resorption and inanbility to metabolise calcium in blood.
Short and brief presentation of anatomy, physiology , disorder and management of parathyroid glands.
management of MEN syndrome, hyper and hypoparathyroidism.
disorder of calcium metabolism like tetany,.
surgical steps of parathyroidectomy with indication and complications
Hyperparahyroidsm is an endocrinal disorder majorly affecting the parathyroid glands which secrete parathyroid hormone and calcitonin.
A condition characterised by excessive secretion of calcium in blood and Bone resorption and inanbility to metabolise calcium in blood.
Short and brief presentation of anatomy, physiology , disorder and management of parathyroid glands.
management of MEN syndrome, hyper and hypoparathyroidism.
disorder of calcium metabolism like tetany,.
surgical steps of parathyroidectomy with indication and complications
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
TOP AND BEST GLUTE BUILDER A 606 | Fitking FitnessFitking Fitness
"Feature:
• Intelligent Ergonomically Design Glute Builder Is A Must Have For Those Looking To Target Their Gluteal Muscles And Hamstrings With Precision.
• The Ability To Adjust The Starting Position, This Machine Allows For A More Targeted Workout That Is Tailored To Your Specific Needs.
• Spacious And Supportive Cushioned Seat Provide Added Comfort And Stability During Your Workout."
Get more information visit on:- www.fitking.in
Our mail I.D:-care@fitking.in, fitking.in@gmail.com
Call us at :- 9958880790, 9870336406, 8800695917
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
3. PARATHYROID GLANDS
• Four or more small glands embedded on posterior
surface of thyroid gland.
• Each gland is about the size of a grain of rice (weighs
approximately 30 milligrams and is 3-4 millimeters
in diameter).
• Produces Parathormone (PTH).
• Regulates calcium and phosphate levels in an inverse
relationship.
• Calcium levels major controlling factor of PTH
secretion.
4.
5. PARATHYROID FUNCTION
• Parathormone, the protein hormone from
the parathyroid glands, regulates calcium
and phosphorus metabolism.
• Increased secretion of parathormone
results in increased calcium absorption
from the kidney, intestine, and bones,
thereby raising the blood calcium level.
• Some actions of this hormone are increased
by the presence of vitamin D.
6. CONT...
• Parathormone also tends to lower the blood
phosphorus level.
• Excess parathormone can result in markedly
elevated levels of serum calcium, a potentially
life-threatening situation.
• When the product of serum calcium and
serum phosphorus (calcium and phosphorus)
rises, calcium phosphate may precipitate in
various organs of the body and cause tissue
calcification.
7. CONT...
• The serum level of ionized calcium
regulates the output of parathormone.
• Increased serum calcium results in
decreased parathormone secretion,
creating a negative feedback system.
9. HYPERPARATHYROIDISM
• When your parathyroid glands create too
much parathyroid hormones in the blood
steam.
OR
• Over activity of one or more of the
parathyroid glands.
• Incidence
Greatest numbers after 60 years
Females males (2:1)
10. Hyperparathyroidism
• Hyperparathyroidism, which is caused by
overproduction of parathyroid hormone by the
parathyroid glands, is characterized by bone
decalcification and the development of renal
calculi (kidney stones) containing calcium.
11.
12. Hyperparathyroidism Classifications
• Primary related to secreting tumor of the
parathyroid gland.
Hyperplasia
Adenoma
• Develops when the normal regulatory relationship
between serum calcium levels and parathyroid
hormone secretion is interrupted.
• Primary hyperparathyroidism is related to no
injury, just a parathyroid gone bad.
13. CONT...
• Increased calcium in the kidneys - kidney stones;
• Increased calcium in the small intestines -
gastrointestinal upset;
• Increased bone resorption occurs, this means there
is increased bone demineralization, bone damage,
osteoporosis.
• These symptoms are part of what is known as the
moans and groans, stones and bones.
14. Hyperparathyroidism Classifications
•Secondary- occurs when the glands are
hyperplastic because of malfunction of another organ
system. Usually the cause is renal failure or
hyperphosphatemia.
• Compensatory response to chronic hypocalcaemia.
Vitamin D deficiency
Malabsorption
Result of renal failure
Hyperphosphatemia
17. Pathophysiology
• Normal function of PTH is to increase
bone reabsorption, thereby
maintaining proper balance of calcium
and phosphorus ions in the blood
• Excessive circulating PTH leads to
bone damage, hypercalcemia, and
kidney damage
18. Clinical Manifestations
• Skeletal disease ( backache, joint pain, bone pain,
pathologic fracture of spine, ribs and long bones).
• Renal involvement (polyuria, polydipsia, gravel, or stones
in the urine, azotaemia, hypertension).
• GI manifestations (thirst, nausea, anorexia, constipation,
abdominal pain, peptic ulcer, GI bleeding, and
pancreatitis).
• Psychiatric manifestations (lethargy, fatigue, depression,
memory loss, confusion, coma, paranoia are sometimes
associated with high calcium levels).
22. Medical/Surgical Management
To Lower elevated calcium levels
• By Hydration and Calcinuria
• Lasix to promote calcinuria after rehydration has occurred IV
saline solutions both expands volume and acts in the kidney to
inhibit reabsorption of calcium.
• Diet low in calcium and vitamin D
Oral or IV phosphates
Antiresorption Agents
Calcitonin
Mithracin ( Plicamycin)
Glucocorticoids decrease Gl absorption of calcium.
23. Hyperparathyroidism- Medical
Management
• Goal is to lower severely elevated calcium
levels.
• Long term management of hypercalcemia
with drugs to increase bone reabsorption of
calcium.
27. High risk for injury R/ted to demineralization
of bones resulting in pathologic fractures.-
• Prevent accidents (keep bed in low position,
use side rails, help with ambulation).
• Space activities, plan rest periods.
• Encourage weight bearing 30mins/day to
promote bone rebuilding.
• Avoid high-impact activities or sports.
• Home should be cleared of articles that can
increase risk of falling such as throw
rugs/carpet.
28. Impaired urinary elimination related to renal
involvement secondary to hypercalcemia and
hypophosphaturia resulting in urolithiasis,
painful urination, haematuria and spasms.
Encourage fluids (2-3000ml /day)
• Prevent urolithiasis ( cranberry juice helps
in making urine more acidic which helps in
preventing renal stone: formation as
calcium is more soluble in acidic urine
than in alkaline urine)
29. Imbalanced nutrition less than body
requirements related to anorexia
resulting in decreased food intake and
weight loss.
•Low calcium diet to correct hypercalcemia
•Antacids for clients with peptic ulcer
•Diet high in calories without dairy
products
30. Constipation r/ted adverse effects of
hypercalcemia on GI tract resulting in
decreased frequency of stools and painful
defecation.
• Add fiber to diet
• Increase fluid intake.
• Use stool softeners or laxatives
Knowledge Deficit Related to Dietary Changes
• Low calcium diet
• Limit milk products
31. Risk For Renal Stones
Increase fluid intake (2-3000ml/day)
Encourage cranberry juice
• Assess for:
flank pain
hematuria
32. Nursing management of surgical
client
•Monitor for post-op complications:
Haemorrhage, airway obstruction,
recurrent injury to laryngeal nerve.
Eat foods high in calcium.
Encourage ambulation as soon as after
surgery as weightbearing exercises
speeds recalcification
34. Hypoparathyroidism
• Deficiency of PTH due to hyposecretion of
Parathyroid glands Serum calcium levels
are abnormally low, serum phosphate
levels are abnormally high and tetany may
develop.
Incidence Women are more prone
than men Incidence related to thyroid
surgery.
35. Hypoparathyroidism- CAUSES
• Iatrogenic i.e.- treatment induced (removal of
viable parathyroid tissue)
Surgery (accidental removal during
thyroidectomy.
Infarction of parathyroid glands because of
an inadequate blood supply to the glands
during surgery.
Trauma.
Idiopathic- autoimmune disorder.
36. Pathophysiology
Due to the etiological causes
Decrease in the gland function
Resistance to PTH action
Inadequate PTH secretion and increased reabsorption of Ca
in GI tract
Blood calcium fall to low level
Muscular hyper irritability
Uncontrolled spasm, hypo calcaemic tetany
39. Assessment
• Physical Assessment –
Acute Hypoparathyroidism
Positive CHVOSTEK SIGN (spasms of facial
muscle after a tap over the facial nerve signifying
facial nerve hyper irritability) and TROUSSEAU
SIGNS (Spasm of wrist and hand after
compression of upper arm as by BP cuff.)
Hyperactive Deep Tendon Reflexes
Paraesthesia:- Numbness and tingling of fingers
41. Hypoparathyroidism- Assessment
•Diagnostic Tests-
Decreased serum Calcium(<4.8mEq/l)
Increased serum Phosphate (>1.75mEq/l)
Low PTH levels
Decreased Urine Calcium
Ophthalmic exam: calcification of lens
Radiograph- increased bone density of Skull
42. Hypoparathyroidism- Medical
Management
• Active Form of Vit D-to maintain Ca
Rocaltrol
Hytakerol (Dihydortachysterol)
• IV Calcium –
10% Calcium Chloride or Calcium Gluconate Emergency Treatment
• Supplemental Calcium
Oral
Dietary
Address seizures and laryngeal spasms ( Ca gluconate, tracheostomy set )
Parathyroid hormone replacement
43. Hypoparathyroidism –
Nursing Management
•Knowledge Deficit of Dietary Management/
Medications
High calcium, low phosphate
avoid milk and cheese (high in phosphorus).
Calcium rich food: Beans, Almonds, 7 dark green
leafy vegetables (spinach).
Discuss medications and ensure compliance with
treatment.
44. CONT…
•High risk for injury: muscle tetany
related to hypocalcaemia
- Assess chvostek and trousseau signs
- Assess for twitching, numbness and tingling,
- Seizures
- Safety precautions for seizures
- Maintain patent airway, keep trach set at
bedside
- Keep ampoule of IV calcium at bedside