Calcium

Question 1

What does Ca+ do for the body?

Answer 1

8.5 - 10.5 mg/ dL
Keep our 3 B’s strong
- Bone
- Beats
- Blood Clotting
Ca+ is regulated by PTH, Calcitonin, Calcitrol
Ca+ and Mg+ are best friends = when one goes up the other follows

Question 2

How does PTH regulate Ca+?

Answer 2

Parathyroid gland makes and releases when Ca+ levels are low

Question 3

How does Calcitonin regulate Ca+?

Answer 3

Calcitonin is regulated by the thyroid
Calcitonin is released when Ca+ levels are high to lower Ca+ and put back into the bone

Question 4

How does Calcitrol regulate Ca+?

Answer 4

Vitamin D analog
Calcitrol controls blood calcium by suppressing release of PTH
PTH increases blood calcium levels; calcitonin decreases blood calcium levels

Question 5

What is IONIZED CALCIUM?

Answer 5

4.8 - 5.6 mg/ dl
Calcium that isn’t attached to any protein which is called free calcium
Most accurate test for assessing true calcium status
Important if abnormal levels of proteins
May be drawn if signs of bone, kidney, liver, or parathyroid disease

Question 6

What can cause HYPOcalcemia?

Answer 6

Vitamin D deficiency
Long term Corticosteroids
Hyperparathyroidism
Renal disease
Massive diarrhea
Hyperphosphatemia = inverse RS with Ca+
Medications = diuretics; laxatives; corticosteroids (contribute to bone loss)

Question 7

How does Hypoparathyroidism affect HYPOcalcemia?

Answer 7

Decrease in parathyroid hormone
Removal of parathyroid glands

Thyroidectomy or any neck surgeries can inadvertently irritate or remove parathyroid glands

Question 8

What are the S/S of HYPOcalcemia?

Answer 8

Hypotension
Dysrhythmias (V Tach)
Decreased HR
Twitching, cramps, tetany, seizures, parasthesias
Painful muscle spasms in calf or foot
Positive Trousseau’s and Chvosteks signs
Hyperactive DTRs
Osteoporosis - body trying to get more calcium
Hyperactive bowel sounds
Diarrhea

Question 9

What are some nursing interventions for HYPOcalcema??

Answer 9

Replace calcium IV or PO
- calcium gluconate over 10 - 20 min
- make sure to monitor BP, HR and use a heart monitor
Initiate seizure & bleeding precautions
Move pt carefully
Ca+ rich diet

Question 10

What are causes of HYPERcalcemia?

Answer 10

Hypoprathyroidism
Antacids
- excessive oral intake of Ca+ & Vit D
Malignancies
- of the bone; bone destruction Ca+ is released into the bloodstream
Renal disease
- not able to excrete

Question 11

What are the S/S of HYPERcalcemia?

Answer 11

Muscle weakness
Diminished or absent DTR
Constipation
Kidney stones

Question 12

How to remember Kidney stones?

Answer 12

Kidney stones, painful bones, abd moans from constipation, N/V

Question 13

What are nursing interventions for HYPERcalcemia?

Answer 13

Administer IV fluids
Discontinue Ca+
Loop diuretics
Phosphorus med
- inverse RS with Ca+
Calcitonin med
Dialysis if meds fail
Educate on avoiding Ca+ rich foods
IV NS and loop diuretics = less severe