Primary hyperparathyroidism: a case study.
Primary hyperparathyroidism is a hypercalcemic condition generated as a result of overproduction of parathyroid hormone (PTH) by one or more of the parathyroid glands. The cause is usually an abnormal group of cells forming a benign adenoma and rarely carcinoma. The condition is usually discovered by routine serum chemistry analysis showing hypercalcemia, hypophosphatemia, and elevated PTH levels. Elevated 24-hour urine calcium provides further confirmation. During the last decade, three procedures have been developed to help diagnose the affected parathyroid gland(s) in preparation for surgical intervention: computerized nuclear scanning with technetium-99-m sestamibi performed preoperatively; radio-guided probes; and rapid PTH assay (RPHA), both used intraoperatively. These three techniques have been reported to reduce the need for immediate frozen section diagnosis; shorten the length of the incision, surgical time, and length of hospital stay; produce less pain and discomfort; reduce surgical cost; and produce a quicker return to normal life. This article follows the surgical experience of a patient with a diagnosis of hyperparathyroidism and a history of postoperative nausea and vomiting who was scheduled as 23-hour stay.
De Manicor
Nancy A
NA
Mesa View Regional Hospital, Mesquite, Nevada 89027, USA. Nancy.Demanicor@triadhospital.com
D001706:Biopsy; D002116:Calcitonin / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002762:Cholecalciferol / Q000378:metabolism; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D024802:Nurse's Role; D010281:Parathyroid Hormone / Q000378:metabolism; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D019990:Perioperative Care / Q000379:methods / Q000451:nursing*; D016528:Postanesthesia Nursing / Q000379:methods; D016634:Radiosurgery / Q000379:methods; D017256:Technetium Tc 99m Sestamibi
D010281:Parathyroid Hormone; D002762:Cholecalciferol; D002116:Calcitonin; D017256:Technetium Tc 99m Sestamibi; D002118:Calcium