1. Increased secretion of PTH that results in an altered
state of calcium, phosphate, and bone metabolism
2. Most commonly affects women between ages 35-65
3.
Primary
hyperparathyroidsim: caused by tumor or
hyperplasia of parathyroid glands
4.
Secondary
hyperparathyroidism: caused by compensatory over secretion of PTH disease,
rickets, malabsorption syndrome, osteomalacia
B. Assessment findings
1. Bone pain (especially at back), bone
demineralization, pathologic fractures
2. Renal colic, kidney stones, polyuria, polydipsia
3. Anorexia, nausea, vomiting, gastric ulcers,
constipation
4. Muscle weakness, fatigue
5. Irritability, personality changes, depression
6. Cardiac arrhythmias, hypertension
7. Diagnostic tests
a. Serum calcium levels elevated
b. Serum phosphate levels decrease
c. Skeletal x-rays reveal bone demineralization
1. Administer IV infusions of normal saline solution and
give diuretics as ordered; monitor I & O and observe for fluid overload and
electrolyte imbalances
2. Assist client with self-care: provide careful
handling, moving, and ambulation to prevent pathologic fractures
3. Monitor vital signs; report irregularities
4. Force fluids; provide acid-ash juices, e.g.,
cranberry juice
5. Strain urine for stone
6. Provide low-calcium, high-phosphorous diet
7. Provide care for the client undergoing
parathyroidectomy
8. Provide client teaching and discharge planning
concerning
a. Need to engage in progressive ambulatory activities
b. Increased intake of fluids
c. Use of calcium preparations and importance of
high-calcium diet following a parathyroidectomy