Calcium- Exam 5 🦴 Flashcards
Normal lab levels for Ca+
8.5-10.5 mg/dl
Calcium is best friends with what other electrolyte?
Magnesium +
What are the three Bs associated with calcium
- Bone
- Blood clotting
- Beat
Bone is
90% of the body’s calcium
If calcium is low what happens to blood clotting
More risk for bleeding
If calcium is low what happens to the HR
Myocardial contractions
Parathyroid gland makes and release when Ca+ levels are low
Parathyroid hormone
Regulated by the thyroid
Calcitonin
Released when Ca+ levels are high to lower Ca+ and out back into the bone
Calcitonin
Controls blood calcium by suppressing release of PTH
Calcitrol
PTH increases what
Blood calcium levels
Calcitonin decreases what
Blood calcium levels
Hypocalcemia levels
< 8.5 mg/dl
Causes for Hypocalcemia
- vitamin D deficiency
- long term corticosteroids
- hypoparathyroidism
- renal disease
- massive diarrhea
- hyperphosphatemia **
- medications
In a patient with Hypocalcemia what do we look out for in cardiovascular
- hypotension
- dysrhythmias
- decreased HR
In a patient with Hypocalcemia what do we look for in neuromuscular
- irritable skeletal muscles
- tetany, sz, paraesthesis ***
- painful muscle spasms in calf or foot
- positive Trousseaus and Chvosteks signs ***
- hyperactive DTRs
- osteoporosis
In a patient with Hypocalcemia what do we look for in GI
- hyperactive bowel sounds
- diarrhea
Tapping the skin over facial nerve
Chvosteks
Inflating a BP cuff on arm
Trousseaus
What IV fluid do we give a patient with Hypocalcemia
Calcium Gluconate 10% over 10-20mins
When a patient is receiving calcium Gluconate via IV what do you monitor?
BP
HR
And place patient on monitor
Hypocalcemia interventions
- replace calcium IV or PO
- vitamin D if giving PO
- Tums ~ calcium supplements
- initiate sz precautions & bleeding precautions
- move patient carefully
- educate on calcium rich foods
Hypercalcemia level
> 10.5 mg/dl
2 main causes of Hypercalcemia
1- hyperparathyroidism
2- malignancies
In a patient with Hypercalcemia what neuromuscular symptoms do we look for
- muscle weakness
- diminished or absent DTRs
In a patient with Hypercalcemia what GI symptoms do we look for
Hypoactive bowel sounds = constipation
In a patient with Hypercalcemia what symptoms do we look for in renal
Kidney stones
A patient with Hypercalcemia what Iv fluids do we administer?
0.9% saline - to get kidneys to excrete calcium
What medications do we give to a patient with Hypercalcemia
- loop diuretics ~ furosemide
- phosphorus
- calcitonin
-biphosphorus
What do we discontinue in a patient with Hypercalcemia
Calcium - oral meds with calcium and vitamins
If medications don’t help a patient with Hypercalcemia what would we do next
Dialysis
What do we educate to a patient with Hypercalcemia
On avoiding calcium rich foods
