 Wacom to nursing school explained in this video on hyper and hypoperathyroidism. So to take a quick look here at what the parathyroid gland is and does. So the parathyroid glands are actually forward glands that sit on top of the thyroid gland in the neck. And the parathyroid gland is in charge of regulating calcium and phosphorus levels in our body. So when the parathyroid gland detects low levels of calcium in the body, it stimulates the release of parathyroid hormone which in turn helps to increase calcium and lower down phosphorus levels. And these have an inverse relationship here as you can see calcium goes up phosphorus goes down. So in turn when there's high calcium levels in the blood, the parathyroid gland will lower down the release of parathyroid hormone which will decrease serum calcium and increase serum phosphorus levels. Whenever we think about parathyroid gland knowing that it regulates these two major electrolytes, we have to think about things that those electrolytes regulate in our bodies to help us understand signs and symptoms and causes. So for calcium and phosphorus always think muscles, bones and stones for signs and symptoms. And please refer to my videos in the fluid and electrolyte playlist where I go into calcium and phosphorus disorders in more detail. So now when we have hypo parathyroidism, it's pretty uncommon but it can be genetic. But patients are at risk for hypo parathyroidism if they have a history of any kind of neck radiation. So any kind of cancer that they might have had to the skin to their voice box or the larynx, anything like that can affect the functioning of the parathyroid glands. As well as like I mentioned before, the parathyroid glands are sitting on the thyroid gland and they're very small glands. So if the thyroid is removed by a thyroidectomy, there is a chance that the parathyroid glands go with it. And so now we don't have parathyroid glands, we don't have parathyroid hormone, hence we have hypoperathyroidism. On the opposite side here, hyperparathyroidism is usually caused by primary hyperparathyroidism, meaning that there is something primarily wrong with the gland itself. And most likely that is because of an adenoma, so some sort of abnormal growth that affects the glands. But again, it can also make the gland, put the gland in hyperfunction because of head or neck radiation. And then prolonged therapy of lithium can also lead to hyperparathyroidism. Signs and symptoms for low functioning parathyroid glands includes numbness and tingling, particularly to the fingers and circumeral, so around the mouth. It might lead to cramps and tetany. It might increase the patient's deep tendon reflexes and also cause a positive schwastik and trossosine. And these are all related when we have low parathyroid, then we usually have low calcium levels. And remember that calcium helps us with our muscle contraction and relaxation. And so most of these are related to the skeletal muscle function. When we have hyperparathyroidism, it can lead to osteoporosis all the way to fractures. And that is because of, again, the calcium. So when we have too much parathyroid, we have too much calcium in the serum. And what that means is that calcium now has been pulled from the bone because 99% of our calcium is actually stored in our bones. But now if that parathyroid gland is overworking and increasing that parathyroid hormone, it wants to increase the serum level. Well, the easiest way to do it is to pull it from the bone and put it into the serum. And then the bones become brittle, hence osteoporosis and fractures. With that increased level of calcium due to hyperparathyroidism, we can have patients that develop kidney stones because most kidney stones are made of calcium oxalate. So those are because of those high levels in the serum that are not clogging up the renal tubules. And then in addition, we will have decreased deep tendon reflexes with hyperparathyroidism because of the high calcium level. So it's the opposite of hyperparathyroidism. And then in terms of complications, so hyperparathyroidism because of all these calcium imbalances can lead to renal failure. Osteoporosis and fractures, like we mentioned, can lead to bradycardia. So it can affect the heart muscle all the way to a heart block. And then again, kidney stones can be assigned, but also a complication. Diagnostic tests, we want to evaluate the patient's level of parathyroid hormone, calcium and phosphorus. We want to check their kidney function because we know that can lead to complications, BUN and creatinine. We want to check their bone density because we know it can lead to osteoporosis and fractures. And then check a CT MRI ultrasound to evaluate for the primary causes of hyperparathyroidism here. Check for an adenoma treatment. When we have hypoperathyroidism, we want to give the patient calcium because we know that their level will be low. And that can either be PO or in the IV with calcium gluconate if the levels are really low. For hyperparathyroidism, most likely if it is primary hyperparathyroidism, most likely because of an adenoma, the glands will have to be removed. And then we also want to make sure that we hydrate the patient to prevent kidney stones or help the patient pass those kidney stones a little bit easier if they have developed those. Nursing care. So it's very important to be aware of the function of the parathyroid gland and identify patients at risk for imbalances in calcium and phosphorus because of malfunctioning of that parathyroid gland. And like I said before, over here, most likely causes neck or head radiation as well as after thyroidectomy. So if you're caring for a patient after a thyroidectomy or any kind of neck surgery or radiation, just keep in mind that it might affect the parathyroid as well as their calcium and phosphorus balances. We want to check that vital signs because we know it can affect everything. And then the check neuromuscular signs for cramps, that tingling, deep tendon reflexes that we talked about in signs and symptoms, check their labs, parathyroid hormone, calcium, phosphorus, and then kidney function with BUN and creatinine, like we discussed over here. Put the patient on a hard monitor because we know that it can cause heart blocks, bradycardia, those kinds of symptoms. So keep an eye on that. And then if, if we do have hyperparathyroidism, so if the calcium has been pulled from the bone, we want to recommend weight bearing exercises and hydration again to prevent or help treat and get rid of those pesky kidney stones. Please also I highly encourage you to watch the calcium and phosphorus imbalances videos in my fluid and electrolyte balance so you can really tie it all together, the information. And keep in mind that with calcium and phosphorus having this inverse relationship, signs and symptoms of hypercalcemia, high calcium, will be pretty much the same as signs and symptoms of hypophosphatemia because they have this inverse relationship that we discussed over here. Thanks for watching Nursing School Explained. Please give me a thumbs up if you've enjoyed the video and I'll see you soon right here for the next video. Thanks for watching.