Calcium Imbalnace
Hypercalcemia
Hypocalcemia
calcium is necessary for the structure of bone and teeth, blood clotting, transmission of nerve impulses, myocardial contraction and muscle contraction
Vitamin D is needed to absorb Ca
Dietary intake is primary source
low albumin levels result in drop in total calcium level
controlled by the parathyroid gland and calcitonin
PTH is produced when levels are low to increase bone, GI, and renal tubule resorption
Calcitonin is produced by the thyroid gland and lowers serum calcium levels
10.2 mg/dL and above
8.6 mg/dL and below
caused by hyperparathyroidism
other causes malignancy such as myeloma and breast, lung, & kidney cancers
ECG changes: shortened ST segment and QT interval, ventricular dysrhythmias, increased digitalis effect
CM: lethargy, weakness, depressed reflexes, confusion, N/V, anorexia, decreased, memory, personality changes
Treatment: Loop diuretics to increase renal excretion and isotonic saline infusions to hydrate patient and lower chance of kidney stone formation, diet modifications, weight-bearing activity
laxative abuse and malabsorption syndromes can cause low serum calcium levels
think nerve excitability and and sustained muscle contraction
Chvostek's sign - contraction of facial muscles in response to a tap over the facial nerve in front of the ear
Trousseau's sign - refers to carpal spasms induced by inflating a blood pressure cuff on the arm ... spasms occur for 3 minutes
Causes: chronic kidney disease, vitamin D deficiency, magnesium deficiency, diarrhea,k chronic alcoholism, and acute pancreatitis
CM: tetany, seizures, depression, anxiety, confusion, muscle cramps, numbness and tingling in extremities and around mouth, easy fatigability
ECG changes: elongation of ST segment, prolonged QT interval, ventricular tachycardia
Treatment: dietary supplements or diet high in calcium, measure CO2 retention, treat pain and anxiety