Hypocalcemia

Question 1

Normal range of calcium

Answer 1

9.0-10.5

Question 2

Function of calcium

Answer 2

Critical for bone health and muscle contraction, including those of the heart
Strong teeth
Help in blood clotting
Regular heartbeat

Question 3

Role of parathyroid hormone in managing calcium

Answer 3

Increase blood calcium by stimulating calcium release from the bones
Stimulate vitamin D activation to help increase intestinal absorption of dietary calcium
Inhibit kidney of calcium excretion
Stimulate kidney calcium reabsorption to blood

Question 4

With which electrolytes calcium has opposite relation

Answer 4

Phosphorus

Question 5

Role of parathyroid hormone in blood phosphorus

Answer 5

Decrease blood phosphorus levels by stimulating phosphorus excretion by the kidneys

Question 6

Role of calcitonin in blood calcium

Answer 6

Decreased blood calcium levels by stimulating calcium storage in the bones and excretion by kidney
Inhibit vitamin D associated intestinal uptake of calcium

Question 7

In which body organ does calcium absorbed

Answer 7

Intestinal tract

Question 8

Where does the calcium stored

Answer 8

Bone

Question 9

Causes of hypo-calcium

Answer 9

LOW CALCIUM
Low parathyroid hormone, lactose intolerance
Oral intake inadequate (alcoholism, bulimia, anorexia)
Wound drainage (especially GI system where calcium absorbed)
Celiac or crohn’s diseases
Acute pancreatitis
Low vitamin D levels
Chronic kidney issues
Increased phosphorus level
Using medication such as magnesium supplements, laxatives, diuretics
Mobility issues

Question 10

Signs and symptoms of hypocalcemia

Answer 10

Findings of increased neuromuscular irritability
CRAMPS
Confusion
Reflexes hyperactive
Arrhythmias (prolonged QT and ST interval)
Muscles cramps in calves or feet, tetany, seizures
Positive trousseaus sign
Signs of Chvostek’s signs

Hypotension
Diarrhea

Question 11

How to test trousseau’s sign

Answer 11

1. Place a blood pressure cuff around arms
2. Inflate the cuff greater than patient’s systolic pressure
3. Keep the cuff inflated for 1-4 minutes
4. Under the hypoxic condition, a positive trousseaus’s sign occurs when the hand and fingers go into the spasms in palmar flexion

Question 12

How to test Chvostek’s sign

Answer 12

Tap the face just below and in front of the ear to trigger facial twitching of one side of the mouth, nose and cheeks

Question 13

Interventions

Answer 13

Administer calcium supplements (oral or IV)
IV calcium gluconate is used to treat severe ECG changes
Give IV therapy slowly to prevent dyrhythmias
Increase calcium rich foods such as diary and green leafy vegetables
Monitor phosphorus level
Administered oral calcium with vitamin D supplement

Question 14

Why you shouldn’t you give digoxin to hypocalcemia patients

Answer 14

Low calcium levels significantly reduce the effectiveness of digoxin
Correct calcium levels before starting digoxin therapy