Hyperparathyroidism: Nursing

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Hyperparathyroidism is a condition characterized by an increase in blood levels of the parathyroid hormone, or PTH for short, which ultimately results in hypercalcemia, or high blood calcium levels, as well as hypophosphatemia, or low blood phosphate levels.

Now, PTH is produced by four small glands called the parathyroid glands. These glands lie in the neck, being stuck to the back surface of the thyroid gland. The main function of PTH is keeping the levels of calcium within the normal range. For example, when calcium levels are low, PTH boosts bone resorption, which causes the release of calcium and phosphate from the bone into the bloodstream. In addition, PTH activates vitamin D, which in turn increases calcium and phosphate absorption from the gut. PTH also stimulates calcium reabsorption and phosphate excretion from the kidney. On the other hand, high calcium levels cause the secretion of PTH to fall, which increases the deposition of calcium in bones and the excretion of calcium by the kidneys.

Alright, now based on the underlying cause, hyperparathyroidism may be classified into three types. First is primary hyperparathyroidism, which is caused by congenital hyperplasia, parathyroid tumor or cancer, and neck radiation or trauma. Next is secondary hyperparathyroidism, which happens as a compensatory response to a condition outside the parathyroid glands that’s causing hypocalcemia, including vitamin D deficiency, chronic kidney disease, and PTH-secreting carcinomas of the lung and kidneys. Finally, there is tertiary hyperparathyroidism, which can happen in clients who had long standing secondary hyperparathyroidism, in which the parathyroids have been producing high levels of PTH for so long that they undergo hyperplasia, or enlargement, and stop responding to feedback from calcium levels in the blood. As a result, the parathyroids become permanently overactive, independently of blood calcium levels.


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