tsi vmptoms the wurse will shuerve if the paruthyroid gland is injured or remove
ID: 3165622 • Letter: T
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tsi vmptoms the wurse will shuerve if the paruthyroid gland is injured or removed during surgery You are looking at patients in the waiting room, without knowing any of their test results describe what endocrine system im physical appearance. balance you would guess they would have based on their 1. An enlarged thyroid (goiter)- 2. Large bulging eyes- 3. Large mass on their upper back- 4. Large facial features and extremities- wide forehead, large chin 5. Dwarfism- 6. A woman holding a baby and is unable to nurse properlyExplanation / Answer
List the symptoms the nurse will observe if the parathyroid gland is injured or removed during surgery.
Ans. About Parathyroid glands: Parathyroid glands are two pairs of endocrine glands present on thyroid gland which are responsible for the production of parathormone (PTH). PTH maintains the blood calcium levels by:
1. Increasing the resorption of calcium from the bones
2. Reabsorption of calcium from renal tubules
3. Absorption of calcium from gastrointestinal tract.
Hyperparathyroidism results in increased levels of parathormone that increases the levels of calcium in blood. Parathyroidectomy involves surgical removal of one or more parathyroid glands in cases of Hyperparathyroidism.
If the parathyroid gland is removed or injured the symptoms the nurse can see in the patient are:
1. Hypocalcemia: As seen from the above discussion, Parathormone is responsible for maintainence of calcium in the blood. As PTH is not produced when parathyroid glands are removed or injured, it may lead to hypocalcaemia which may be characterised by the symptoms of numbness of fingertips, toes, hands and oral region. Muscle cramps or twitching can also be seen in some cases.
Hence, Vitamin D and Calcium supplements are administered for the patient after parathyroid glands are removed to counteract Hypocalcemia
2. Hoarseness of voice: This may be caused due to the injury incurred to the laryngeal nervees that control the vocal cords during the surgical removal of parathyroid glands
3. Haemorrhage in the neck: Hemorrhage and Hematoma are seen in the area where parathyroid glands are injured or improperly removed during surgery.
4. Infection: If parathyroidectomy is not properly done or when the parathyroid glands are injured it may also lead to infection which requires immediate medical attention and start of antibiotic therapy
1. An enlarged thyroid gland (goitre): Goter refers to the abnormality of thyroid glands. It occurs in both Hypothyroidism and Hyperthyroidism.
Goiter in Hyperthyroidism: It is the enlargement of thyroid gland due to the increased secretion of thyroid hormones caused by thyroid tumor. Because of the increased hormone levels induced by tumor secreting cells of thyroid, it is called as toxic goiter
Goter in Hypothyroidism: It is the enlargement of thyroid gland without increase in hormone secretion. It can be classified into Endemic colloid goiter where iodine deficiency is the cause and Idiopathic non toxic goiter where the exact cause is not known. Some theories suggest that thyroiditis leads to Idiopathic non toxic goiter
2. Large bulging eyes: It is also the abnormality of thyroid glands called as Grave's disease which is an autoimmune disorder in which Thyroid stimulating Autoimmune antibodies (BTSAB) are produced by B lymphocytes. Thus produced antibodies activates cAMP system of thyroid follicular cells which inturn produces high levels of thyroid hormones. The antibodies supress the concentration of Thyroid stimulatin hormone.
Large bulging of eyes called as Exopthalmos in hyperthyroidism is due to the edematous swelling of the retro-orbital tissues and degenerative changes in extraocular muscles induced by the autoimmune disorder.
3. Large mass on their upper back: It may be due to the Hyperactivity of the Adrenal cortex causing Cushing's syndrome in which there is hypersecretion of glucocorticoids (especially cortisol).
Cushing's disease may be due to the increased secretion of Adrenocorticotrophic hormone (ACTH) from pituitary that stimulates the adrenal cortex to produce more glucocorticoids.
It may also be Adrenal gland origin in which there is tumor of zona fasciculata, carcinoma of adrenal cortex, overuse of glucocorticoids for inflammatory diseases, over doses of ACTH.
Fat deposition on the back appears like buffalo hump which is a characteristic of Cushing's disease
4. Large facial features and extremities-wide forehead, large chin: This is due to the hypersecretion of Growth hormone by anterior pituitary gland causing ACROMEGALY. Acromegaly occurs when there is growth hormone hypersecretion in adults after the fusion of epiphysis with shaft of the bone. Acromegaly may be due to adenomatous tumor of anterior pituitary involving the acidophil cells
The features of acromegaly are guerrilla like face with protrusion of supraorbital ridges, broad nose, thickened lips, protrusion of lower jaw, wrigled wide-forehead, large extremities, large chin etc
5. Dwarfism: It is also a pituitary disorder in which there is reduced Growth hormone (GH) secretion in children, as a result there is stunted growth leading to dwarfism. The causes may be due to deficiency of GHrH(GH releasing hormone from hypothalamus), deficiency of somatomedin C, Tumor of chromophobes, panhypopituitarism.
6. A woman holding a baby and is unable to nurse properly: It may be due to the Deficiency/insufficient secretion of Prolactin from anterior pituitary. Prolactin is a polypeptide with 199 aminoacids which is responsible for production and secretion of milk from mammary glands in females. Prolactin Inhibiting hormone hypersecretion from hypothalamus may also result in this problem
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