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Hypocalemia & Hypercalcemia Cheat Sheet by

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.
 

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
 
Bispho­sph­onates
 
Calcium chelators

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  • Published: 6th December, 2018
  • Last Updated: 4th January, 2019

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