This document discusses hypoparathyroidism, which occurs when the parathyroid glands do not produce enough parathyroid hormone, leading to low calcium and high phosphorus levels in the blood. It defines different types, describes symptoms like muscle spasms and numbness. Diagnosis involves lab tests to check calcium, phosphorus and PTH levels. Treatment focuses on calcium supplementation through oral or IV routes as well as medications to bind phosphorus.

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
Introduction:-

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

4. 1. 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.)
2. Transient hypoparathyroidism (occurs most commonly in babies who
are born too soon (prematurely)
3. Congenital hypoparathyroidism or DiGeorge's
syndrome (The parathyroid glands do not develop properly while the baby is
growing in the womb)
4. Inherited hypoparathyroidism (caused by an inherited problem
caused by chemicals called antibodies attacking the parathyroid gland. This is
called an autoimmune illness)
Types/Classification:-

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.
Etiology:-

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
C/M:-

8.  Dysphagia
 Photophobia
 Cardiac dysrhythmias
 Convulsion

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
Medical Management:-

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:-