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HYPOCALCEMIA: Risk Factors
Hypoparathyroidism |
Hypomagnesemia |
Kidney failure |
Vitamin D deficiency |
Inadequate intake |
GI loss (wound drainage, diarrhea) |
Celiac disease |
Lactose intolerance |
Chron's disease |
Alcohol use disorder |
HYPOCALCEMIA: Manifestations
Tetany, cramps |
Paresthesia |
Dysrhythmias |
Trousseau's sign |
Chvostek's sign |
Seizures |
Hyperreflexia |
Impaired clotting time |
HYPOCALCEMIA: Nursing Interventions
Seizure precautions |
IV calcium replacement |
Daily calcium supplements |
Vitamin D therapy |
Monitor for orthostatic hypotension |
Dietary increase and education |
HYPOCALCEMIA: Notes
IV calcium must be administered slowly and the site monitored for extravasation. |
It is diluted in D5W, NEVER normal saline. |
Calcium has an inverse relationship with phosphorus.
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HYPERCALCEMIA: Risk Factors
Hyperparathyroidism |
Malignant disease |
Prolonged immobilization |
Dehydration |
Vitamin D excess |
Thiazide diuretics |
Lithium |
Glucocorticoids |
Digoxin toxicity |
Overuse of calcium supplements |
Hyperthyroidism |
HYPERCALCEMIA: Manifestations
Muscle weakness |
Hypercalciuria/kidney stones |
Dysrhythmias |
Lethargy/coma |
Hyporeflexia |
Pathologic fractures |
Flank pain |
Deep bone pain |
Polyuria |
Polydipsia |
Dehydration |
Hypertension |
Nausea |
Vomiting |
HYPERCALCEMIA: Nursing Interventions
Increase mobility |
Medications |
Isontonic IV fluids |
Furosemide |
Dialysis |
Calcitonin |
Cardiac monitoring |
Glucocorticoids |
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Bisphosphonates |
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Calcium chelators |
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