Med-Surg Ch. 63, Care of Patients with Problems of the Parathyroid Glands

What is the most common cause of hyperparathyroidism?

Benign tumor in a parathyroid gland

Which class of drugs is most appropriate for treating severe hyperparathyroidism?

Calcimimetics

A patient is suspected of having hyperparathyroidism. Which treatment strategy would be therapeutically effective in this patient?

Calcitonin with glucocorticoids

What are the parathyroid glands responsible for maintaining?

Calcium and phosphate balance

What is a common cause of hypoparathyroidism?

Congenital dysgenesis

What is the consequence of the action of parathyroid hormone on the bones?

Decreased osteoblastic

The nurse teaches a patient with hyperparathyroidism about actions the patient can take to specifically reduce the incidence of renal calculi. Which action by the patient indicates effective learning?

Drink large amounts of water and fluids

A patient diagnosed with parathyroid cancer is prescribed cinacalcet. Arrange the sequence in order of how the drug helps treat the condition.

Drug binds to calcium-sensitive receptors Reduces parathyroid hormone production (PTH) and release Decreases serum calcium levels Decreased parathyroid hormone-induced bone complications

If a patient has hyperparathyroidism and receives hydration therapy, how often does the nurse monitor the patient?

Every 2 hours

The nurse knows to assess serum calcium levels for the patient with hyperparathyroidism because of which mechanism?

Increased reabsorption of calcium by the kidneys

Which conditions can be suspected in a patient with hypomagnesemia? Select all that apply.

Malnutrition Chronic kidney disease Malabsorption syndrome

An older patient with an elevated serum calcium level is receiving IV furosemide and an infusion of normal saline at 150 mL/hr. Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP)?

Measure the patient's intake and output hourly.

While assessing a patient with hypoparathyroidism, the patient reports tingling and numbness of the hands and feet. Which condition does the nurse suspect?

Moderate hypocalcemia

Which patient does the nurse identify as at risk for possible hypoparathyroidism?

Patient who has congenital dysgenesis

The primary health care provider prescribes cinacalcet to a patient with hyperparathyroidism; however, the patient failed to respond to the medication. What is the alternative treatment of choice for this patient?

Phosphates

What postoperative assessment finding in a patient who underwent a parathyroidectomy indicates potential tetany?

Positive for Trousseau's test

What finding during the physical assessment of a patient does the nurse associate with hypoparathyroidism?

Presence of bands

What manifestation does the nurse expect to find in a patient with hyperparathyroidism?

Presence of renal calculi

The nurse observes that the serum calcium level for a patient with hyperparathyroidism is 12.5 mg/dL. Which other health problems can this condition lead to? Select all that apply.

Psychosis Osteoporosis Peptic ulcer formation

The nurse is caring for a patient with hypocalcemia due to hypoparathyroidism. What is the cause of iatrogenic hypoparathyroidism?

Removal of the parathyroid glands

The nurse is providing instructions about dietary changes to a patient with hypoparathyroidism. Which statements made by the patient indicates effective learning? Select all that apply.

"I will avoid milk." "I will avoid yogurt." "I will avoid processed cheese."

A nurse is caring for a patient with hyperparathyroidism. Which laboratory finding indicates a high risk of psychosis?

Serum calcium 15 mg/dL

What food is appropriate for the patient with hypoparathyroidism to include in the diet?

Soy milk

What is hyperplasia?

Tissue overgrowth

Which is a cause of hyperparathyroidism?

Vitamin D deficiency

A nurse is assessing a patient suspected of having hyperparathyroidism. Which questions asked by the nurse would be helpful to assess the patient? Select all that apply.

"Do you have a history of fractures?" "Do you have a history of joint pain?" "Do you have a history of radiation therapy to the neck?"

The nurse assesses a patient who presents with symptoms of hyperparathyroidism. Which questions does the nurse ask the patient during the assessment? Select all that apply.

"Do you have any bone fractures?" "Have you lost or gained any weight recently?" "Have you received any radiation treatment to the neck or head?"

The registered nurse is teaching a student nurse about caring for a patient with hyperparathyroidism. Which statement made by the student nurse indicates a need for further teaching?

"I will teach the patient to eat foods high in calcium and low in phosphorus."

The patient receives an order for 100,000 units of oral ergocalciferol to take daily to treat hypoparathyroidism related to vitamin D deficiency. The patient is informed that the dosage will be adjusted throughout the therapy, but the patient is confused about why. What does the nurse tell the patient?

"Your calcium levels need to be in the low range to prevent the risk of kidney stones."

Which patient with parathyroid disorder is at risk of coma?

A patient with serum calcium levels of 14 mg/dL

What kinds of gastrointestinal (GI) problems are common when serum calcium levels are high? Select all that apply.

Anorexia Vomiting Constipation

Place these steps in the correct order of occurrence, in regards to the action of the drug cinacalcet.

Binding to calcium-sensitive receptors Reduction in the parathyroid hormone production Decreased serum calcium levels Decreased progression of parathyroid hormone induced bone complications

What are the possible findings of a radiographic analysis performed on a patient with hyperparathyroidism? Select all that apply.

Bone cysts Renal calculi Osteoporosis

What is the treatment modality for acute vitamin D deficiency?

Calcitriol 0.5-2mg daily

Upon reviewing the medical reports of a patient with hypoparathyroidism, the nurse notices the serum calcium level as 8 mg/dL. What would be the appropriate long-term therapy in this patient?

Calcium

What is the consequence of the action of the parathyroid hormone on the kidneys?

Calcium reabsorption and phosphorus excretion

A patient had a parathyroidectomy 18 hours ago. Which finding requires immediate attention?

Hoarseness

What does hyperparathyroidism cause?

Hypercalcemia

What type of parathyroid disorder would the nurse expect to find in patients with chronic kidney disease?

Hypomagnesemia

Which electrolyte disturbance causes hypoparathyroidism?

Hypomagnesemia

What is the most common form of hypoparathyroidism?

Iatrogenic

What parathyroid disorder is associated with a total thyroidectomy?

Iatrogenic hypoparathyroidism

What does the nurse teach a patient with hypoparathyroidism about treating hypocalcemia?

Include foods that are high in calcium.

A patient with hyperparathyroidism is prescribed calcitonin with glucocorticoids. How does this drug work to lower serum calcium levels?

It reduces the release of skeletal calcium.

The nurse is caring for a patient receiving hydration therapy. What does the nurse expect if there is a sudden drop in calcium levels?

Muscle numbness

The nurse cares for a patient whose laboratory report shows serum calcium levels of 13 mg/dL. Which action does the nurse take next?

Notify the health care provider.

Which symptom is usually present with mild to moderate hypocalcemia?

Numbness

The nurse is reviewing the medical records of a patient with hypoparathyroidism. Which nursing interventions should be implemented? Select all that apply.

Oral administration of 2 mg calcitriol daily Intravenous administration of 10% calcium chloride Intravenous administration of 50% magnesium sulfate

The assessment findings of a patient with a history of radiation therapy to the neck show bone degeneration and an electrolyte imbalance. What could be the possible diagnosis?

Parathyroid disorder

Which statement describes hypoparathyroidism?

Parathyroid function is reduced

The nurse is reviewing the clinical data of four patients. Which patient is at high risk for bone fractures?

Patient A

The nurse is reviewing the clinical data of four patients. Which patient is at high risk for peptic ulcers?

Patient C

The nurse is caring for four patients with endocrine disorders. Which patient is likely to present with a positive Chvostek's and Trousseau's sign?

Patient D

The registererd nurse (RN) has just received a change-of-shift report on the medical-surgical unit. Which patient should be assessed first?

Patient who had a parathyroidectomy yesterday and has muscle twitching

The nurse is assessing a patient with a parathyroid disorder. Which laboratory values would be associated with a diagnosis of hypoparathyroidism? Select all that apply.

Serum magnesium level of 1 mEq/L Serum phosphorus level of 6.5 mg/dL Urine cyclic adenosine monophosphate (cAMP) level of 17 nmol/L

While assessing a patient with hypoparathyroidism, the nurse observes severe muscle cramps and elbow flexion. Which condition does the nurse suspect?

Sever hypocalcemia

A patient is suspected of having hyperparathyroidism. The primary health care provider diagnoses the cause as hyperplasia. What treatment would be most effective for this condition?

Surgical removal of nearly all parathyroid glands

A patient has hyperparathyroidism. Which incident witnessed by the nurse requires the nurse's intervention?

Unlicensed assistive personnel (UAP) pulling the patient up in bed by the shoulders

A patient receives a diagnostic workup of laboratory tests to check for hyperparathyroidism. Which findings indicate an increased risk of hyperparathyroidism? Select all that apply.

Urine cAMP 52.7 nmol/L Serum magnesium 3.8 mEq/L Serum parathyroid hormone C-terminal 450 pg/mL

A patient is prescribed 50,000 units of ergocalciferol daily. What disorder does this drug treat?

Vitamin D deficiency

The nurse is assessing a patient with a parathyroid disorder. Which laboratory findings would support a diagnosis of hyperparathyroidism? Select all that apply.

Vitamin D level of 30 ng/mL Serum calcium level of 11 mg/dL Serum phosphorus level of 2.5 mg/dL Urine cyclic adenosine monophosphate (cAMP) level of 55 nmol/L

Which is a nonsurgical treatment for hypoparathyroidism?

Vitamin therapy

What integumentary change does the nurse expect while assessing the skin of a patient with hyperparathyroidism?

Waxy pallor

The nurse educates the patient with hypoparathyroidism about dietary intake and nutrition. Which food selection made by the patient indicates further teaching is required?

Yogurt with banana