Hyperparathyroidism — NCLEX Cheat Sheet
↑ PTH → ↑ Ca, ↓ phosphateAlso known as: high parathyroid · overactive parathyroid · high calcium from parathyroid · too much PTH
Use this quick-reference guide to spot, treat, and prevent Hyperparathyroidism on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
📌 Mechanism
- ↑ PTH pulls Ca from bones
- Parathyroid adenoma common
🧪 Labs
- ↑ Ca >10.5, ↓ phosphate
- ↑ PTH level
🩺 Signs
- Bones, stones, groans, moans
- Fractures, kidney stones, ↓ DTR
- Constipation, weakness, fatigue
✅ Do
- Hydrate, ↑ fluids, ambulate
- Parathyroidectomy, bisphosphonates
- Report Ca >13 → cardiac risk
📚 Hyperparathyroidism — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- PTH excess causes hypercalcemia and hypophosphatemia.
- Bone resorption leads to bone pain, osteoporosis, and increased fracture risk ('bones').
- Hypercalcemia promotes kidney stones, polyuria, and risk of renal damage ('stones').
- GI effects include anorexia, nausea, constipation, and abdominal pain ('abdominal groans').
- Neuromuscular and psychiatric effects include muscle weakness, fatigue, depression, and confusion ('psychiatric moans').
Nursing priorities
What to do, in order- Encourage increased fluid intake (often 3-4 L/day) to prevent kidney stones and promote calcium excretion.
- Monitor cardiac rhythm, as hypercalcemia can cause dysrhythmias.
- Promote mobility and weight-bearing activity to limit bone calcium loss, while preventing falls and fractures.
- Administer medications such as bisphosphonates, calcitonin, or IV fluids/loop diuretics as ordered to lower calcium.
- Prepare and care for the patient undergoing parathyroidectomy when indicated, monitoring for postoperative hypocalcemia.
Red flags — report now
Escalate immediately- Report severe hypercalcemia with cardiac dysrhythmias, marked confusion, or decreased level of consciousness.
- Report signs of pathologic fracture or severe bone pain.
- After parathyroidectomy, watch for sudden hypocalcemia causing tetany, numbness, and tingling.
Labs & values
Numbers to know- Calcium: elevated (normal 9.0-10.5 mg/dL)
- Phosphorus: low (normal 3.0-4.5 mg/dL)
- PTH: elevated (normal 10-65 pg/mL)
Patient teaching
What patients must know- Drink plenty of fluids to reduce the risk of kidney stones.
- Stay physically active and weight-bearing to protect bones, and use fall precautions.
- Report bone pain, flank pain, or symptoms of kidney stones to the provider.
❓ Hyperparathyroidism: NCLEX FAQs
What are the priority nursing interventions for Hyperparathyroidism?
Encourage increased fluid intake (often 3-4 L/day) to prevent kidney stones and promote calcium excretion. Monitor cardiac rhythm, as hypercalcemia can cause dysrhythmias. Promote mobility and weight-bearing activity to limit bone calcium loss, while preventing falls and fractures. Administer medications such as bisphosphonates, calcitonin, or IV fluids/loop diuretics as ordered to lower calcium.
What are the warning signs of Hyperparathyroidism a nurse must report?
Report severe hypercalcemia with cardiac dysrhythmias, marked confusion, or decreased level of consciousness. Report signs of pathologic fracture or severe bone pain. After parathyroidectomy, watch for sudden hypocalcemia causing tetany, numbness, and tingling.
What do I need to know about Hyperparathyroidism for the NCLEX?
PTH excess causes hypercalcemia and hypophosphatemia. Bone resorption leads to bone pain, osteoporosis, and increased fracture risk ('bones'). Hypercalcemia promotes kidney stones, polyuria, and risk of renal damage ('stones'). GI effects include anorexia, nausea, constipation, and abdominal pain ('abdominal groans').
What patient teaching is important for Hyperparathyroidism?
Drink plenty of fluids to reduce the risk of kidney stones. Stay physically active and weight-bearing to protect bones, and use fall precautions. Report bone pain, flank pain, or symptoms of kidney stones to the provider.
Quick Tip
PTH excess causes hypercalcemia and hypophosphatemia.
📖 Related Topics
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