Chapter 17: Fluids and Electrolytes-Hypocalcemia Flashcards

1
Q

How can the calcium level be determined with hypoalbuminemia?

A

(4 – measured albumin level) × 0.8, then add this value to the measured calcium level

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2
Q

What are the surgical causes?

A
  • Short bowel syndrome
  • intestinal bypass
  • vitamin D deficiency
  • sepsis
  • acute pancreatitis
  • osteoblastic metastasis
  • aminoglycosides
  • diuretics
  • renal failure
  • hypomagnesemia
  • rhabdomyolysis
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3
Q

What is Chvostek’s sign?

A

Facial muscle spasm with tapping of facial nerve (Think: CHvostek = CHeek)

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4
Q

What is Trousseau’s sign?

A

Carpal spasm after occluding blood flow in forearm with blood pressure cuff

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5
Q

What are the signs/symptoms?

A
  • Chvostek’s and Trousseau’s signs
  • perioral paresthesia (early)
  • increased deep tendon reflexes (late)
  • confusion
  • abdominal cramps
  • laryngospasm
  • stridor
  • seizures
  • tetany
  • psychiatric abnormalities (e.g., paranoia, depression,hallucinations)
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6
Q

What are the ECG findings?

A

Prolonged QT and ST intervals (peaked T waves are also possible, as in hyperkalemia)

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7
Q

What is the acute treatment?

A

Calcium gluconate IV

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8
Q

What is the chronic treatment?

A

Calcium PO, vitamin D

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9
Q

What is the possible complication of infused calcium if the IV infiltrates?

A

Tissue necrosis; never administer peripherally unless absolutely necessary (calcium gluconate is less toxic than calcium chloride during an infiltration)

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10
Q

What is the best way to check the calcium level in the ICU?

A

Check ionized calcium

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