Calcium

Question 1

Although calcium is no longer recommended during resuscitation attempts, it may be used to treat other potential H’s and T’s, what other issues may calcium be administered to reverse?

Answer 1

Suspected hyperkalemia, hypocalcemia, calcium-channel blocker or beta-blocker overdose.

Question 2

What is the difference between calcium gluconate and calcium chloride?

Answer 2

Calcium chloride has approximately three times the amount of elemental calcium as calcium gluconate, however either may be used.

Question 3

What is calcium’s MOA in hyperkalemic patients?

Answer 3

Calcium antagonizes the cardiotoxicity of hyperkalemia by stabilizing the cardiac cell membrane against undesired depolarization and prevent VF

Question 4

What are indications that calcium is administered for hyperkalemic patients?

Answer 4

• Peaked T-waves do not indicate the need.
• Severe hyperkalemia (>7 mEq/L)
• Widening of QRS
• Dropped P-waves
• Cardiac arrhythmias

Question 5

Does calcium have an effect of serum potassium levels?

Answer 5

No, so other therapeutic interventions are necessary to adjust serum potassium levels

Question 6

How much calcium does 1g of calcium gluconate have?

Answer 6

90 mg (4.5 mEq)

Question 7

How much calcium does 1g of calcium chloride have?

Answer 7

270 mg (13.5 mEq)

Question 8

What dosage does calcium chloride normally come in?

Answer 8

100mg/ml

Question 9

What must the IV be and why when administering calcium?

Answer 9

Calcium is very harsh and a patent IV must be established, central line is preferred.

Question 10

What medication should calcium not be mixed with and why?

Answer 10

Sodium bicarbonate because precipitation will occur.