Calcium: Fluid Electrolyte

Calcium (Ca+) Normal Range

9-10.5

Hypocalcemia <9

Hypercalcemia >10.5

Calcium Purpose

transmission of nerve impulses

bone and teeth

blood clotting

regulate muscle and cardiac muscle

Hypocalcemia <9 Causes

• decreased calcium intake

• vitamin D def

• Decreased protein

• CKD

• Acute pancreatitis

• Alcholism/malnutrition

Hypocalcemia Manifestations

• Tetany

• Chvostek’s sign (facial nerve tap→facial twitch)

• Trousseau’s sign (hand spasm caused by a blood pressure cuff)

• Neuro: anxiety, seizure, muscle twitch, spasm

• Cardiac: porlong QT interval, hypotension

• Resp: increased, distress, stridor

Hypocalcemia Nursing Intervention

• Cardaic monitoring

• Resp: monitor distress/stridor

Hypocalcemia Diet

dairy produces

canned salmon

green leafy veggies

Hypocalcemia Medication

• oral Ca+ supplements

• Vitamin D

• IV Calcium gluconate/chloride

Hypercalcemia Causes

• hyperparathyroidism

• Bone malignancies

• Immobilization

• Thiazide diuretics

Hypercalcemia Manifestation

• Bone fracture/pain

• Neuro: confused, lethargy, coma, weak, fatigue

• Cardio: Short QT, HTN

• GI: Anorexia, N/V, constipation, Hypoactive bowel sounds

Hypercalcemia Nursing Intervention

• intake and output

• increase fluid intake 3-4 L

• Neuro: monitor status

• Cardio: monitor rate/rhythm

Hypercalcemia Medications

• Loop Diuretics: Lasix

• IVF: isotonic NSS

• Calcitonin