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HYPOCALCEMIA: Risk FactorsHypoparathyroidism | Hypomagnesemia | Kidney failure | Vitamin D deficiency | Inadequate intake | GI loss (wound drainage, diarrhea) | Celiac disease | Lactose intolerance | Chron's disease | Alcohol use disorder |
HYPOCALCEMIA: ManifestationsTetany, cramps | Paresthesia | Dysrhythmias | Trousseau's sign | Chvostek's sign | Seizures | Hyperreflexia | Impaired clotting time |
HYPOCALCEMIA: Nursing InterventionsSeizure precautions | IV calcium replacement | Daily calcium supplements | Vitamin D therapy | Monitor for orthostatic hypotension | Dietary increase and education |
HYPOCALCEMIA: NotesIV 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. | | HYPERCALCEMIA: Risk FactorsHyperparathyroidism | Malignant disease | Prolonged immobilization | Dehydration | Vitamin D excess | Thiazide diuretics | Lithium | Glucocorticoids | Digoxin toxicity | Overuse of calcium supplements | Hyperthyroidism |
HYPERCALCEMIA: ManifestationsMuscle weakness | Hypercalciuria/kidney stones | Dysrhythmias | Lethargy/coma | Hyporeflexia | Pathologic fractures | Flank pain | Deep bone pain | Polyuria | Polydipsia | Dehydration | Hypertension | Nausea | Vomiting |
HYPERCALCEMIA: Nursing InterventionsIncrease mobility | Medications | Isontonic IV fluids | Furosemide | Dialysis | Calcitonin | Cardiac monitoring | Glucocorticoids | | | Bisphosphonates | | | Calcium chelators |
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