Hypoparathyroidism

After thyroid or neck surgery, new tingling around the mouth or in the fingers may be the first visible sign that falling ionized calcium is affecting nerves and muscle. Progression can produce carpopedal spasm, laryngospasm, seizures, QT prolongation, and dysrhythmias. Hypoparathyroidism is not simply a low-calcium disorder: absent PTH also raises phosphate and reduces calcitriol production, so the laboratory pattern and treatment differ from other causes of hypocalcemia. The immediate nursing priority is to recognize symptomatic hypocalcemia and protect airway and cardiac function; long-term therapy replaces calcium and active vitamin D while limiting hypercalciuria and renal injury.