Endocrine Drugs and Medications Q 18
When caring for a client taking parathyroid medication, which of the following nursing interventions is a priority?
A. Monitor serum calcium levels
B. Evaluate bowel function
C. Measure serum acid phosphatase
D. Check for side effects
Correct Answer: A. Monitor serum calcium levels
Serum calcium levels are altered when pathology exists in this gland. This is because the gland regulates the balance of calcium and phosphorus. In the bones, PTH stimulates the release of calcium in an indirect process through osteoclasts which ultimately lead to resorption of the bones. Most of the physiologic calcium reabsorption in the nephron takes place in the proximal convoluted tubule and additionally at the ascending loop of Henle.
Option B: In the small intestine, vitamin D allows the absorption of calcium through an active transcellular pathway and a passive paracellular pathway. The transcellular pathway requires energy, while the paracellular pathway allows for the passage of calcium through tight junctions.
Option C: Parathyroid hormone decreases phosphate reabsorption at the proximal convoluted tubule. Phosphate ions in the serum form salts with calcium that are insoluble, resulting in a decreased plasma calcium. The reduction of phosphate ions, therefore, results in more ionized calcium in the blood.
Option D: The 2 umbrella categorizations of parathyroid dysfunctions are hyperparathyroidism and hypoparathyroidism. The inappropriately high secretion of PTH is classified as hyperparathyroidism while the inappropriately low secretion of PTH is designated as hyperparathyroidism.