Calcium- Exam 5 🦴

Question 1

Normal lab levels for Ca+

Answer 1

8.5-10.5 mg/dl

Question 2

Calcium is best friends with what other electrolyte?

Answer 2

Magnesium +

Question 3

What are the three Bs associated with calcium

Answer 3

1. Bone
2. Blood clotting
3. Beat

Question 4

Bone is

Answer 4

90% of the body’s calcium

Question 5

If calcium is low what happens to blood clotting

Answer 5

More risk for bleeding

Question 6

If calcium is low what happens to the HR

Answer 6

Myocardial contractions

Question 7

Parathyroid gland makes and release when Ca+ levels are low

Answer 7

Parathyroid hormone

Question 8

Regulated by the thyroid

Answer 8

Calcitonin

Question 9

Released when Ca+ levels are high to lower Ca+ and out back into the bone

Answer 9

Calcitonin

Question 10

Controls blood calcium by suppressing release of PTH

Answer 10

Calcitrol

Question 11

PTH increases what

Answer 11

Blood calcium levels

Question 12

Calcitonin decreases what

Answer 12

Blood calcium levels

Question 13

Hypocalcemia levels

Answer 13

< 8.5 mg/dl

Question 14

Causes for Hypocalcemia

Answer 14

• vitamin D deficiency
• long term corticosteroids
• hypoparathyroidism
• renal disease
• massive diarrhea
• hyperphosphatemia **
• medications

Question 15

In a patient with Hypocalcemia what do we look out for in cardiovascular

Answer 15

• hypotension
• dysrhythmias
• decreased HR

Question 16

In a patient with Hypocalcemia what do we look for in neuromuscular

Answer 16

• irritable skeletal muscles
• tetany, sz, paraesthesis ***
• painful muscle spasms in calf or foot
• positive Trousseaus and Chvosteks signs ***
• hyperactive DTRs
• osteoporosis

Question 17

In a patient with Hypocalcemia what do we look for in GI

Answer 17

• hyperactive bowel sounds
• diarrhea

Question 18

Tapping the skin over facial nerve

Answer 18

Chvosteks

Question 19

Inflating a BP cuff on arm

Answer 19

Trousseaus

Question 20

What IV fluid do we give a patient with Hypocalcemia

Answer 20

Calcium Gluconate 10% over 10-20mins

Question 21

When a patient is receiving calcium Gluconate via IV what do you monitor?

Answer 21

BP
HR
And place patient on monitor

Question 22

Hypocalcemia interventions

Answer 22

• 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

Question 23

Hypercalcemia level

Answer 23

> 10.5 mg/dl

Question 24

2 main causes of Hypercalcemia

Answer 24

1- hyperparathyroidism
2- malignancies

Question 25

In a patient with Hypercalcemia what neuromuscular symptoms do we look for

Answer 25

• muscle weakness
• diminished or absent DTRs

Question 26

In a patient with Hypercalcemia what GI symptoms do we look for

Answer 26

Hypoactive bowel sounds = constipation

Question 27

In a patient with Hypercalcemia what symptoms do we look for in renal

Answer 27

Kidney stones

Question 28

A patient with Hypercalcemia what Iv fluids do we administer?

Answer 28

0.9% saline - to get kidneys to excrete calcium

Question 29

What medications do we give to a patient with Hypercalcemia

Answer 29

• loop diuretics ~ furosemide
• phosphorus
• calcitonin
  -biphosphorus

Question 30

What do we discontinue in a patient with Hypercalcemia

Answer 30

Calcium - oral meds with calcium and vitamins

Question 31

If medications don’t help a patient with Hypercalcemia what would we do next

Answer 31

Dialysis

Question 32

What do we educate to a patient with Hypercalcemia

Answer 32

On avoiding calcium rich foods