The nurse is performing an assessment of a client at risk of acute hypoparathyroidism and notes a positive Chvostek’s sign. What other indicators should the nurse assess for acute hypoparathyroidism?
• Hypoparathyroidism is a decreased secretion of PTH due to destruction of the parathyroid glands (autoimmune or post-surgical), abnormal parathyroid gland development, or altered regulation of parathyroid hormone production and secretion.
• The most common cause of hypoparathyroidism is surgical, and it is usually accompanied by hypocalcemia which occurs when parathyroid hormone (PTH) secretion is insufficient to act on kidney, bone, and intestine to normalize serum calcium.
• Chvostek's sign is contraction of the facial muscles elicited by tapping the facial nerve just anterior to the ear, causing facial twitching or spasm if hypocalcemia is present.
• Numbness around the mouth, tingling in the hands and feet, and a positive Trousseau's sign are all indicative of acute hypoparathyroidism.
• Dry skin, brittle nails and hair, Parkinsonian syndrome, and tooth enamel hypoplasia are all signs of chronic hypoparathyroidism.