Calcium Flashcards
calcium range
9-11
where is calcium stored?
bones
function of calcium
bones
blood
beats
found in 3 forms
bound
ionized (50%)
complexed
what does ionized ca+ do?
-activate body chemicals reaction
-muscle contractions and relaxation
-promote transmission of nerve impulse
-cardiac contractility and automacitiy
-formation of prothrombin
what regulates ca+?
PTH
calcitonin
phosphate
vitamin D
Hypocalcemia causes
Low PTh
Oral intake inadequate
Wound drainage
Celiacs, crohns, corticosteroids
Acute pancreatitis
Low vit D levels
Hypocalcemia signs and symptoms
Confusion
Reflexes hyperactive
Arrhythmias
Muscle spasms - tetany
Positive trousseaus
Signs of Chvosteks
Trousseaus sign is a spasm where?
hand
chvosteks sign is a spasm where
facial nerve (cheek)
hypocalcemia cardiac effects
-prolonged QT interval
-prolonged ST segment
-decreased cardiac contractility
-decreased sensitivity to digoxin
hypocalcemia lab data
ca+ <9
albumin/protein level
PTH level
Mg and Phos levels
hypocalcemia medical treatment
-acute symptomatic low Ca is an emergency - requires prompt admin of IV Ca+
-10% Ca-gluconate (severe)
-Ca-Cl
-oral Ca+ or Vit D
hypocalcemia nursing interventions
-identify pt at risk
-seizure precautions
-monitor airway, ECG
-educate pt on Ca+ loss and risks and Ca+ rich foods
hypercalcemia causes
Hyperparathyroidism
Increased intake of Ca
Glucocorticoids usage
Hyperthyroidism
Calcium excretion w/ thiazide diuretics and renal failure, bone cancer
Adrenal insufficiency (addisons)
Lithium usage (affects parathyroid)
hypercalcemia signs and symptoms
Weakness of muscles
EKG changes
Absent reflexes, disoriented, abd. distention from constipation
Kidney stone formation
hypercalcemia - cardiac changes
-reduces heart rate
-potentiate dig. toxicity
hypercalcemia lab data
calcium >11
ECG - dysrhythmias
PTH increased
X-ray reveals osteoporosis
hypercalcemia medical treatment
-treat underlying cause
-dilute serum Ca with NS
-lasix/furosemide
-IV phosphate
-calcitonin
-glucocorticoids
-hemodialysis or CAPD
hypercalcemia nursing interventions
-identify pt at risk (thyroid, immobile)
-high activity and fluids if possible
-low Ca+ intake
-safety measures for confusion
-monitor ECG, I&O, breath sounds, Dig. toxicity
-prevent Ca renal stones
