Calcium

Calcium

  • Functions
    • Formation of teeth and bone
    • Blood clotting
    • Transmission of nerve impulses
    • Myocardial contractions
    • Muscle contractions
  • Balance controlled by
    • Parathyroid hormone
    • Calcitonin
  • Hypercalcemia
    • High levels of serum calcium caused by
      • Hyperparathyroidism (two thirds of cases)
      • Malignancy
    • Manifestations
      • Fatigue, lethargy, weakness, confusion
      • Hallucinations, seizures, coma
      • Cardiac dysrhythmias
      • Bone pain, fractures, nephrolithiasis
      • Polyuria, dehydration
    • Nursing diagnosis
      • Risk for electrolyte imbalance related to excessive bone destruction
      • Risk for activity intolerance related to generalized muscle weakness
      • Risk for injury related to neuromuscular and sensorium changes
      • Potential complication: dysrhythmias
    • Nursing implementation
      • Excretion of Ca with loop diuretic
      • Hydration with isotonic saline infusion
      • Low calcium diet
      • Mobilization
      • Bisphosphonates
      • IM or SC calcitonin
  • Hypocalcemia
    • Low serum Ca levels caused by
      • Decreased production of PTH
      • Multiple blood transfusions
      • Alkalosis
      • Increased calcium loss
    • Manifestations
      • Positive Trousseau’s or Chvostek’s sign
      • Laryngeal stridor
      • Dysphagia
      • Tingling around the mouth or in the extremities
      • Cardiac dysrhythmias
    • Nursing diagnosis
      • Risk for electrolyte imbalance related to decreased PTH level
      • Ineffective breathing pattern related to laryngospasm
      • Acute pain related to sustained muscle contractions
      • Risk for injury related to tetany and seizures
      • Potential complications: fracture, respiratory arrest