The endocrine system is composed of glands that produce hormones, which control and regulate important body functions. One of the endocrine glands is the Parathyroid, which secretes the Parathyroid hormone (PTH). The purpose of this guide is to educate nurses on the differences between hyperparathyroidism and hypoparathyroidism.
Causes and Diagnostic Tests
Hyperparathyroidism is a parathyroid condition caused by increased secretion of PTH. PTH acts on receptors in the intestines, kidneys, and bones. Elevated PTH levels act directly on the kidneys, resulting in increased reabsorption of calcium and excretion of phosphate in the kidneys. The outcome is hypercalcemia and hypophosphatemia. Elevated PTH levels in the bones cause increased bone resorption and calcium (Kochman, 2023). On the other hand, hypoparathyroidism occurs following a decreased parathyroid function (Pasieka et al., 2022). It results from Iatrogenic and Idiopathic causes and Hypomagnesaemia. Iatrogenic hypoparathyroidism occurs following the removal of the parathyroid tissue or surgical removal of the parathyroid glands. Idiopathic hypoparathyroidism is caused by autoimmune disorders.
The diagnostic tests for Hyperparathyroidism include measurement of serum calcium, phosphate, and PTH levels and urine cyclic adenosine monophosphate (cAMP) (Kochman, 2023). Diagnostic tests for hypoparathyroidism include blood tests, electroencephalography (EEG), and CT scans. Serum phosphate, calcium, magnesium, vitamin D, and cAMP levels are used to diagnose hypoparathyroidism.
Signs and Symptoms
The signs and symptoms of hyperparathyroidism include anorexia, nausea, vomiting, epigastric pain, weight loss, constipation, bone fractures, arthritis, and psychological distress (Kochman, 2023). Clinical manifestations of hypoparathyroidism are linked to the lack of PTH secretion or diminished efficiency of PTH on target tissue leading to hypocalcemia (Pasieka et al., 2022). Mild to moderate hypocalcemia causes mild tingling and numbness in the mouth, hands, and feet. Severe hypocalcemia causes spasms of hands and feet, muscle cramps, and seizures.
Nurse’s Role in Providing Multidimensional Care
Nurses have a primary role in the care of patients with hyperparathyroidism and hypoparathyroidism. The nurse’s role in caring for a patient with hyperparathyroidism includes monitoring the patient’s cardiac function and fluid intake and output every 2 to 4 hours during hydration therapy (Bandeira et al., 2022). Besides, the nurse has a role in preventing injury caused by pathologic bone fractures. The nurse should be aware that a patient with chronic hyperparathyroidism usually has marked bone density loss and is at high risk for pathologic fractures. Thus, the nurse should take appropriate interventions to prevent falls in the patient, like ensuring they are always escorted when ambulating. The nurse’s role when caring for a patient with hypoparathyroidism includes providing patient education on the medication (Clarke, 2022). Besides, patients are often anxious, and the nurse should teach them measures to alleviate anxiety. The nurse also has a role in providing dietary education like consuming high calcium and low phosphorus foods.
Response to the Interventions
A patient’s response to interventions for hyperparathyroidism can be evaluated by measuring serum calcium, phosphate, and PTH levels (Pavlidis & Pavlidis, 2023). The success of interventions for hypoparathyroidism can be evaluated through EEG. EEG changes get back to normal when hypocalcemia is corrected (Khan et al., 2022).
Conclusion
Hyperparathyroidism is caused by increased secretion of PTH, while hypoparathyroidism is caused by decreased parathyroid function. The signs of Hyperparathyroidism are linked to the effects of elevated PTH or the effects of hypercalcemia. Signs of hypoparathyroidism are due to hypocalcemia.
References
Bandeira, F., de Moura Nóbrega, J., de Oliveira, L. B., & Bilezikian, J. (2022). Medical management of primary hyperparathyroidism. Archives of endocrinology and metabolism, 66(5), 689–693. https://doi.org/10.20945/2359-3997000000558
Clarke, B. L. (2022). Hypoparathyroidism: update of guidelines from the 2022 International Task Force. Archives of endocrinology and metabolism, 66(5), 604–610. https://doi.org/10.20945/2359-3997000000549
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