Case Study #23: Hypoparathyroidism

Kasey Majors | 42 years old

Chief Complaint: Kasey presents with muscle cramps and tingling sensations in her extremities.

Medical History:

• Thyroidectomy due to thyroid cancer (5 years ago)

• Hypothyroidism

• Hypertension

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Nurse's Note: Kasey complains of muscle cramps and tingling sensations in her hands and feet. She appears anxious and reports difficulty swallowing. Chvostek sign is positive.

Labs:

• Serum Calcium: 6.5 mg/dL

• Serum Magnesium: 1.2 mg/dL

• Serum Potassium: 4.0 mEq/L

• Serum Sodium: 138 mEq/L

• TSH: 4.2 mIU/L

• Free T4: 0.9 ng/dL

Vital Signs:

• Blood pressure: 150/90 mmHg

• Heart rate: 90 bpm

• Respiratory rate: 18 breaths/min

• Temperature: 98.6°F (37°C)

Provider Orders:

• Administer IV calcium gluconate 10 mL over 10 minutes.

• Monitor serum calcium levels every 4 hours.

• Place patient on seizure precautions.

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Question 1: What are the common symptoms of hypoparathyroidism?

Question 2: Why is it important to monitor serum calcium levels regularly in patients with hypoparathyroidism?

Question 3: Why is magnesium supplementation initiated in this case?

Answers to Questions Below

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Answers

Question 1: What are the common symptoms of hypoparathyroidism?

Common symptoms include muscle cramps, tingling sensations (paresthesia) in the extremities, tetany (muscle spasms), dysphagia, and irritability. Severe cases may lead to seizures and cardiac dysrhythmias.

Question 2: Why is it important to monitor serum calcium levels regularly in patients with hypoparathyroidism?

Monitoring serum calcium levels helps assess the effectiveness of treatment and prevents complications such as tetany, seizures, and cardiac dysrhythmias. It guides adjustments in calcium supplementation to maintain calcium within the normal range.

Question 3: Why is magnesium supplementation initiated in this case?

Magnesium supplementation is initiated because magnesium deficiency can exacerbate hypocalcemia and neuromuscular symptoms. Magnesium is essential for proper function of calcium channels and contributes to neuromuscular stability.

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