Calcium

Question 1

What are the normal serum ranges for calcium?

Answer 1

9-11 mg/dl

Question 2

What is the main job of calcium?

Answer 2

Causes contraction, coagulation, nerve impulses

Question 3

Calcium levels are inverse with ____

Answer 3

phosphorus

Question 4

What two things regulate calcium levels? How?

Answer 4

Parathyroid hormone and Vitamin D

• Bone reabsorption
• INtestional uptake
• Kidney excretion

Question 5

Explain the three main characteristics of calcium in the ECF

Answer 5

Mostly Protein bound
nearly all of it is chelated
50% of the total calcium is ionized

Question 6

What is the benefit of ionized calcium?

Answer 6

It can leave the vascular compartment and participate in cellular functions

Question 7

What occurs when serum calcium is low?

Answer 7

It increased sodium movement across membranes causing depolarization to occur more easily and inappropriately

Question 8

What are the four main causes of hypocalcemia?

Answer 8

IMpaired ability to mobilize calcium from bone
Decreased intake or absorption
Abnormal renal loss
INcreased protein binding or chelation

Question 9

What can cause an impaired ability to mobilize calcium from the bone?

Answer 9

Hypoparathyroidism

Question 10

What can cause a decreased absorption of calcium?

Answer 10

Protein deficiency

Question 11

What is an important consideration to make r/t blood products and calcium levels?

Answer 11

serum calcium will bind to citrates in blood products and this can have a negative effect if more than 4 units are given in 24h

Question 12

What are some neuromuscular signs of hypocalcemia?

Answer 12

Overstimulation of nerves and muscles
Paresthesias
Trousseau’s sign
Chvostek’s sign

Question 13

What is trousseau’s sign?

Answer 13

The hand curls with bp cuff

Question 14

What is Chvostak’s sign?

Answer 14

Cheek raises with touch

Question 15

What are some cardiovascular signs of hypocalcemia?

Answer 15

ECG changes-long ST and QT

Weak thready pulse

Question 16

What are some GI signs of Hypocalcemia?

Answer 16

increased peristalsis
Cramps
Dihrreah

Question 17

Low calcium often coinsides with low ___ and ___

Answer 17

Potassium and magnesium

Question 18

What are the 4 main interventions for hypocalcemia?

Answer 18

Drug therapy
Nutrition therapy
Environmental managment - Decrease stimuli
Injury prevention -coagulation is low

Question 19

What is the main effect of hypercalcemia?

Answer 19

Excitable tissues need more stimuli to function

Question 20

What 4 things are affected most by hypercalcemia?

Answer 20

the heart
muscles
nerves
intestinal smooth muscles

Question 21

What occurs to clotting with hypercalcemia? what increased risk does this bring?

Answer 21

Clotting becomes faster

DVT risk

Question 22

What are some causes of hypercalcemia?

Answer 22

Regulatory hormones are overwhelmed

Kidneys cant remove excess

Question 23

What are some causes of excess calcium?

Answer 23

Excessive intake
Bone destruction
Prolonged immobilization
Drugs such as lithium and thiazide diuretics

Question 24

What happens to the cardiovascular system with hypercalcemia?

Answer 24

Increased hr and bp changing to decreased
Shortened QT interval
Dysrhythmias
HTN

Question 25

What happens to the muscular system with hypercalcemia?

Answer 25

Weakness

Question 26

What happens to the neurological system with hypercalcemia?

Answer 26

altered LOC

Question 27

What happens to the GI system with hypercalcemia?

Answer 27

Decreased peristalsis

Question 28

What are the three main interventions for hypercalcemia?

Answer 28

Drug therapy
Dialysis
Cardiac monitoring

Question 29

What drug therapy is given for hypercalcemia?

Answer 29

Isotonic fluids to promote kidney excretion

Question 30

What isotonic fluid should not be given for a patient with hypercalcemia?

Answer 30

ringers lactate