Physical Assessment

In conjunction with serum lab values, a physical assessment of the patient as well as information regarding his or her past medical history and psychosocial well-being can better assist the physician in making the correct diagnosis and allow the nurse to provide excellent patient-centered care.

First and foremost, the nurse should obtain the patient’s health history. Questions specific to hypoparathyroidism are listed below:
  • Health History
    • Has the patient ever had a form of neck surgery?
    • Does the patient report having any of the following GI symptoms:
      • Abdominal pain
      • Nausea and vomiting
      • Diarrhea
      • A lack or loss of appetite
  • Does the patient state any of the following symptoms of hypocalcemia (symptoms of hypoparathyroidism are primarily those of hypocalcemia [Huether, McCance, Brashers, & Rote, 2008, p. 460])?
    • Paresthesia (numbness and tingling in the extremities)
    • Increased anxiety
    • Headaches
    • Irritability
    • Depression
  • Does the patient report troubles swallowing or throat tightness?
  • Does the patient report difficulty balancing and/or a history of falls or injuries?
(Sommers, 2011, p. 537).

After collecting the patient’s history, a physical assessment should be performed. Signs to look for specific to hypoparathyroidism are:
  • Dry skin
  • Thin hair with patchy areas of hair loss
  • Ridged fingernails
  • Teeth in poor condition
  • Hoarse voice
  • Unexplained wheezing
  • Involuntary tremors and/or muscle spasms
  • Positive Trousseau’s sign (carpal spasm occurs when a blood pressure cuff is inflated above the patient’s systolic pressure for three minutes)
  • Positive Chvostek’s sign (the patient’s facial muscles twitch when the facial nerve [located anterior to the ear] is tapped).
(Sommers, 2011, p. 538)

Finally, a psychosocial assessment should be performed. Look specifically for these signs and symptoms:
  • Altered behavior (deviation from normal behavior)
  • Irritability
  • Depression
  • Anxiety
  • Inability to cope with symptoms of disease
  • Inability to cope with stressors in daily life
(Sommers, 2011, p. 538)

By: Stephanie Nimmer