Calcium (Regular, hypo, & hypercalcemia)

Question 1

what is the range of calcium

Answer 1

8.5 - 10.5

Question 2

Ca is best friends with which electrolyte

Answer 2

Mg

Question 3

when Ca goes up, Mg goes

Answer 3

up

Question 4

when Mg is low calcium does what for Mg

Answer 4

it helps Mg with the function

Question 5

Ca keeps the 3 B’s what

Answer 5

strong

Question 6

what are the 3 B’s

Answer 6

Bone - 90% of the body’s calcium
Blood clotting
Beat (hr) myocardial contraction

Question 7

where does 90% of the body’s Ca go

Answer 7

the bones

Question 8

what 3 hormones regulate Ca

Answer 8

parathyroid
calcitonin
calcitrol

Question 9

the parathyroid hormone is made and released by what gland

Answer 9

parathyroid gland

Question 10

when Ca+ levels are low what hormone elevates them

Answer 10

PTH

Question 11

calcitonin is regulated by what gland

Answer 11

thyroid gland

Question 12

when Ca+ levels are high, what is released to lower Ca+ and put it back in the bones

Answer 12

calcitonin

Question 13

calcitrol controls blood calcium by suppressing the release of what

Answer 13

PTH

Question 14

what is the normal range of ionized calcium

Answer 14

4.8-5.6

Question 15

What is ionized calcium

Answer 15

calcium in blood not attached to proteins (free calcium)

Question 16

what is the most accurate test for assessing true calcium status

Answer 16

an ionized calcium test

Question 17

why is ionized calcium important

Answer 17

important of there are abnormal levels of protein

Question 18

what signs of these diseases would ionized calcium be drawn (3)

Answer 18

if there are signs of kidney
liver
parathyroid

Question 19

what causes hypocalcemia (7)

Answer 19

vitamin D deficiency
long-term corticosteroids usage
hypoparathyroidism
renal disease
massive diarrhea
hyperphosphatemia
meds

Question 20

what is required for absorption of Ca

Answer 20

Vitamin D

Question 21

what can cause hypoparathyroidism (2)

Answer 21

decrease in parathyroid hormone
removal of parathyroid glands

Question 22

why does hyperphosphatemia cause hypocalcemia

Answer 22

because phospate is in an inverse relationship with calcium

Question 23

what meds can cause hypocalcemia (3)

Answer 23

diuretics
laxitives
corticosteroids (contribute to bone loss)

Question 24

what surgeries can cause possible hypocalcemia due to irritating/possibly removing the parathyroid glands (2)

Answer 24

thyroidectomy
any neck surgeries

Question 25

how will the cardiovascular system appear in a pt who has hypocalcemia (3)

Answer 25

hypotension dysrhythmias (V Tach) decreased hr

Question 26

how will the neuromuscular system appear in a pt with hypocalcemia (5)

Answer 26

irritable skeletal muscles - twitching, cramps, tetany, seizures, paresthesias painful muscle spasms in calf/foot positive Trousseau's & Chvostek's signs hyperactive DTRs osteoporosis - body trying to get more calcium

Question 27

how will the GI system appear in a pt who has hypocalcemia (2)

Answer 27

hyperactive bowel sounds diarrhea

Question 28

what is a positive sign of Chvostek's look like

Answer 28

when taping the masseter on the face, the muscles will contract/twitch

Question 29

what is a positive Trousseau's sign

Answer 29

get a bp cuff and inflate higher than pt's normal systolic hold for 3 mins pos sign: hands draw in as thumb, wrist, & MCP joints flex, fingers stay extended

Question 30

what are the interventions for hypocalcemia

Answer 30

replace calcium (IV or PO) Initiate seizure & bleeding precautions Move pt carefully Educate on calcium-rich food

Question 31

what IV fluid can we give to replace calcium

Answer 31

calcium gluconate 10%

Question 32

how long should we give calcium gluconate

Answer 32

over 10-20 mins

Question 33

what PO meds should we give to replace calcium (2)

Answer 33

Vitamin D tab Aluminum hydroxide (Tums) calcium supplements

Question 34

what causes hypercalcemia (4)

Answer 34

hyperpararthyroidism Antacids Malignancies Renal disease - inability to excrete

Question 35

how do antacids cause hypercalcemia

Answer 35

there is an excess intake of calcium & vitamin D

Question 36

what malignancies cause hypercalemia (2)

Answer 36

bone malignancies bone destruction

Question 37

what is released into the bloodstream with bone malignancies

Answer 37

calcium

Question 38

how will a pt's neuromuscular appear when they have hypercalcemia (2)

Answer 38

muscle weakness diminished or absent DTRs

Question 39

what type of bowel sounds will we hear in a pt who has hypercalcemia

Answer 39

hypoactive bowel sounds

Question 40

what do hypoactive bowel sounds in hypercalcemia indicate

Answer 40

constipation

Question 41

what will form in the kidneys when a pt has hypercalcemia

Answer 41

kidney stones

Question 42

what interventions do we do for hypercalcemia (6)

Answer 42

Admin IV fluids Discontinue calcium Loop diuretics Meds Dialysis if meds fail Educate on avoiding calcium rich foods

Question 43

what IV fluid is admined to pt with hypercalcemia

Answer 43

0.9% NS

Question 44

why is NS the fluid used for a pt with hypercalcemia

Answer 44

to help them excrete the calcium

Question 45

what meds need to be discontinued in a pt with hypercalcemia

Answer 45

oral meds w/ calcium & vitamin D

Question 46

what loop diuretic would be admined to a pt with hypercalcemia

Answer 46

furosemide (lasix)

Question 47

what meds would be given to a pt with hyper calcemia (3)

Answer 47

phosphorus (inverse relationship w/ Ca) calcitonin bisphophonates

Question 48

What do IV NS & loop diuretics indicate about a pt with hypercalcemia

Answer 48

less severe form of hypercalcemia