Chapter 17: Fluids and Electrolytes-Hypocalcemia Flashcards
How can the calcium level be determined with hypoalbuminemia?
(4 – measured albumin level) × 0.8, then add this value to the measured calcium level
What are the surgical causes?
- Short bowel syndrome
- intestinal bypass
- vitamin D deficiency
- sepsis
- acute pancreatitis
- osteoblastic metastasis
- aminoglycosides
- diuretics
- renal failure
- hypomagnesemia
- rhabdomyolysis
What is Chvostek’s sign?
Facial muscle spasm with tapping of facial nerve (Think: CHvostek = CHeek)
What is Trousseau’s sign?
Carpal spasm after occluding blood flow in forearm with blood pressure cuff
What are the signs/symptoms?
- 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)
What are the ECG findings?
Prolonged QT and ST intervals (peaked T waves are also possible, as in hyperkalemia)
What is the acute treatment?
Calcium gluconate IV
What is the chronic treatment?
Calcium PO, vitamin D
What is the possible complication of infused calcium if the IV infiltrates?
Tissue necrosis; never administer peripherally unless absolutely necessary (calcium gluconate is less toxic than calcium chloride during an infiltration)
What is the best way to check the calcium level in the ICU?
Check ionized calcium
