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adult health exam 1 > Calcium > Flashcards

Calcium Flashcards

1
Q

Calcium- Functions

A 
major cation in bone and teeth 
blood clotting 
transmission of nerve impulse 
myocardial contractions 
muscle contractions
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2
Q

how the body regulates calcium

A

source of calcium= diet

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3
Q

how the body regulates calcium- calcium absorption requires

A

active form of vitamin D (diet or sunlight)

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4
Q

how the body regulates calcium- PTH

A

maintain normal serum Ca level by regulating the movement of Ca into/out of bone
Ca readily available supply b/c bone
production and release are stimulated by low serum Ca level
inc bone resorption (movement of Ca out of bone)
inc GI absorption of Ca
inc renal tubule reabsorption of Ca
vit B12 absorption and use
Ca and P have inverse relationship

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5
Q

how the body regulates calcium- to inc Ca: PTH secretion

A

bone
intestine
kidneys

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6
Q

how the body regulates calcium- to dec Ca: Calcitonin

A 
bone 
intestine
kidneys 
produced by thyroid gland
stimulated by high serum Ca level 
Opposes action of PTH and lowers the Ca level by dec GI absorption, inc Ca deposition into bone, promoting renal excretion
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7
Q

how the body regulates calcium- Vitamin D facilitates Ca absorption

A

Dietary intake

sunlight

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8
Q

Calcium info

A

1% in serum
ionized ca- free ca (most active form)
bound to protein (albumin)
complexed bound to other anions

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9
Q

Calcium info: NM activity

A

inc calcium stabilizes excitable membranes (Ca calms)

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10
Q

Calcium info: blood clotting

A 
ca clot (CC) inc ca causes excessive clotting 
dec calcium (DC)- low Ca doesnt clot(bleeding)
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11
Q

Calcium info: teeth and bone formation

A

98% of it found in bone

osteoporosis-> fx

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12
Q

Calcium info: changes in serum pH

A

alter the level of ionized Ca without altering the total Ca level
a dec plasma pH (acidosis) de Ca binding to albumin (more ionized Ca)
inc plasma pH (alkalosis) inc Ca binding leading to dec ionized Ca
alteration in serum albumin levels affect total Ca level
Low albumin levels = drop in total Ca level (BUT the level of ionized Ca is not affected)

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13
Q

Calcium: Pt at risk- Labs

A

8.6-10.62 mg/dL

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14
Q

Hypercalcemia: Pt at risk-

A

high serum ca
excitability of muscles and nerves- need stronger stimulus
2/3 caused by hyperthyroidism
1/3 caused by malignancy from myeloma and breast, lung, and kidney cancer (through bone destruction from tumor invasion, or tumor secretion of a parathyroid related protein), which stimulates Ca release from bone

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15
Q

Hypercalcemia: Pt at risk- prolonged immobilization

A

bone mineral loss and inc plasma Ca concentration

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16
Q

Hypercalcemia: Pt at risk- rare case

A

vit D overdose/ inc Ca intake

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17
Q

Hypercalcemia: Pt at risk- etc

A 
excess Ca- excitability of both muscles and nerves 
hyperparathyroidism 
malignancy 
prolonged immobility 
RF 
multiple bon Fx 
thiazide diuretics- inc action of PTH 
overuse of Ca containing meds 
Steroids- mobilize Ca from bone 
Vit D/Ca overdose
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18
Q

Hypercalcemia: Assessment- dec NM excitability

A

muscle weakness
incoordination
fatigue

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19
Q

Hypercalcemia: Assessment: dec peristalsis

A

dec peristalsis

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20
Q

Hypercalcemia: Assessment: Neuro

A

lethargy, confusion

depressed reflexes

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21
Q

Hypercalcemia: Assessment: flank pain

A

may indicate renal calculi

22
Q

Hypercalcemia: Assessment: dec (Faster) blood clotting time (easy blood clotting)

A

esp lower extremities

risk of DVT

23
Q

Hypercalcemia: Assessment: cardiac

A

dysrhythmias

monitor: HR,BP, O2stats, pallor, EKG charges, DVT, assess blood flow in LE, LE temp

24
Q

Hypercalcemia: Assessment: bone Fx

A

with Ca released from bone

25
Q

Hypocalcemia: Pts at risk

A

inc nerve excitability
can be caused by any condition that dec the production of PTH
surgical removal of parathyroids

26
Q

Hypocalcemia: Pts at risk- meds

A

in loss of ca= hypocalcemia
loop diuretics (lasix- furosemide)
laxative abuse
dec vit D

27
Q

Hypocalcemia: Pts at risk- inc phosphorus

A

combines with Ca-> deposited in tissue

Dec Ca absorption in intestines

28
Q

Hypocalcemia: Pts at risk- pancreatitis

A

lipolysis produces fatty acids that combine with Ca ions dec serum Ca levels

29
Q

Hypocalcemia: Pts at risk- multiple blood transfusion

A

b/c citrate used to anticoagulate the blood binds with the Ca

30
Q

Hypocalcemia: Pts at risk- dec serum albumin levels

A

will dec total Ca

ionized Ca not affected

31
Q

Hypocalcemia: Pts at risk- burned or diseased tissue

A

traps Ca ions from ECF

32
Q

Hypocalcemia: Pts at risk- high pH inc Ca binding to protein

A

dec amt of ionized Ca

33
Q

Hypocalcemia- Assessment: Dec Ca

A

inc Na movement into cells

34
Q

Hypocalcemia- Assessment: most common S&S

A

overstimulation of nerves and muscles

35
Q

Hypocalcemia- Assessment: painful cramps

A

foot, leg, abdomen (diarrhea)

36
Q

Hypocalcemia- Assessment: etc

A 
tingling, numbness
tetany
Trousseau's sign 
chvostek's sign 
inc tendency to bleed (dec clotting)
ECG changes, thread pulse 
high risk for bone Fx
37
Q

Hypocalcemia- Assessment: labs

A

Mg, PTH, P, albumin

38
Q

Hypercalcemia- Nsg Dx: risk for

A

activity intolerance- muscle weakness
electrolyte imbalance- excessive bone destruction
injury- NM and sensorium changes

39
Q

Hypercalcemia- Nsg Dx: potential complications

A

dysrhythmias

40
Q

Hypocalcemia- Nsg Dx: risk for

A

acute pain- sustained muscle contraction
ineffective breathing pattern- laryngospasm
electrolyte imbalance- dec production of PTH
injury- tetany and seizures

41
Q

Hypocalcemia- Nsg Dx: potential complications

A

Fx, respiratory arrest

42
Q

Hypercalcemia- Nursing goals

A

hydration and promote excretion

43
Q

Hypercalcemia- Nursing goals: meds (IV/PO hydration)

A

IV/PO hydration (3000-4000mL daily PO): promotes excretion of Ca and dec kidney stone formation

44
Q

Hypercalcemia- Nursing goals: meds (loop diuretics)

A

inc Ca excretion (basic treatment promoting urinary excretion of Ca and hydrating with isotonic saline infusions)
monitor: UOP, FVD
no thiazide diuretics: inhibits Ca excretion
avoid antacids- most have Ca
Calcitonin- given IM/subcut lowers serum Ca level; intranasal form not effective

45
Q

Hypercalcemia- Nursing goals: mobilize pt

A

wt bearing activity

46
Q

Hypercalcemia- Nursing goals: etc

A

dec dietary Ca intake

safety precaution with LOC

47
Q

Hypocalcemia- Nursing goals: severe hypocalcemia

A

IV preparations of Ca are given

48
Q

Hypocalcemia- Nursing goals: mild hypocalcemia

A

diet high in Ca rich foods along with Vit D supplementation

49
Q

Hypocalcemia- Nursing goals: administer

A

supplements: PO 1-1.5 hrs after meal; IV may be necessary after thyroid surgery
dietary intake Ca with Vit D supplement
if inc P, administer phosphate binding antacids

50
Q

Hypocalcemia- Nursing goals: monitor

A 
bone fx with chronic low Ca
chvotstek's and trousseau's sign
Mg, PTH, Ca, albumin 
cardiac rhythm
observe pt with thyroid or neck srugery

adult health exam 1 (6 decks)

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