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What is the normal range for Ca++?
Ca is obtained how?
Ca existed in the body in what 2 forms?
bound and ionized (bound or free)
When Ca is bound it is usually attached to what?
When measuring Ca lab test measure what type of Ca?
Ca is primary stored where in the body?
What 2 major functions does Ca have on bones?
provides strength and density
What major role does Ca have the muscles?
allows for normal muscle contractions
What major role does Ca play in nerve impulse?
tramission of nerve impulse
What major role does Ca play in blood?
intervenes in normal blood clotting
PTH (releases free ___ from bone storage sites directly into plasma, which is know as __________; Then PTH stimulates _______ ___ activation which increases ________ absorption of dietary Ca, which inhibits _____ excretion of Ca, and stimulates _____ reabsorption of Ca.
- Vitamin D
PTH is stimulated by what?
low Ca++ serum levels (parathyroid)
Calcitonin does what to Ca serum levels? and how does it do it?
- decrease Ca serum levels
- by inhibiting bone resorption (movement of Ca out of bones)
More than 99% of what electrolyte is combine with Ca to be concentrated in the skeletal system?
A decreased plasma pH (acidosis) decreases Ca binding to what? which leads to what?
- albumin (plasma protein)
- more ionized Ca++ (p.317)
An increase plasma pH (alkalosis) increases what? and leads to what?
- Ca binding
- decreased ionized Ca++ (p.317)
Vitamin D is important for absorption of what?
Ca from the GI tract.
What is the abnormal level for hyperCa?
Breast cancer, lung cancer and multiple myeloma are examples of __________ which can cause HyperCa.
What type of hormonal abnormality can cause hyperCa?
What type of overdose can cause HyperCa?
Prolonged what can cause HyperCa?
What 4 cardiac clinical manifestations would you see with a person with HyperCa?
- increase HR
- bounding pulse
What kind of respiratory movements would you see with a person with HyperCa? and why?
- b/c profound skeletal muscle weekness
A person with HyperCa would have impaired what?
Give 2 examples:
- Disorientation and lethergy
A pt with HyperCa would have an increase what? which causes what 2 major things?
- urine output
- dehydration and renal calculi
A pt with HyperCa would have decrease what? which causes what 3 major things?
- GI motility
- hypoactive bowl sounds, abdominal distention, & constipation
A person with HyperCa has a faster what?
What kind of diuretics would you us for a pt with HyperCa?
What kind of solution would you use to hydrate a person with HyperCa?
When treating a person with HyperCa the use of Pilcamycin (Mithracin), penicillamine (Cuprimine, Pendramine) are examples of what? and how do they work?
- Ca binders
- Inhibits bone reabsorption
When treating HyperCa you want to use synthetic what?
Calcitonin and phosphorus
What is a very effective nursing intervention for a person with HyperCa?
When dealing with hyperCa a good nursing care is monitoring what?
When dealing with hyperCa a good nursing care is assessing for what?
When dealing with HyperCa a good nursing care is avoiding what kinds of meds?
meds containing Ca and Vitemin D
When dealing with HyperCa a good nursing care is?
A cause of HypoCa is due to decrease ________ (example) and increase ____ (examples)
- intake (lactose intolerance)
- loss (diarrhea, GI drainage)
HypoCa is caused by decrease production of wha?
Based on the notes list the 5 causes of HypoCa in bullet 3?
Hyperproteinemia, alkalosis, acute pancreatits, Hyperphosphatemia, removal of parathyroid gland.
_____ failure can cause HypoCa
Mal-absorptions problems such as _____ ________ can cause HypoCa
A person with HypoCa has frequent painful _____ spasms (example) in what 2 areas? and normally at what times?
- calfs and foot
- rest or sleep
For a person with HypoCa you want to ask the about what type of history?
thyroid disease or surgery
What 2 circulatory manifestations would you notice with a person with HypoCa?
decrease pulse and BP
What 4 things would you notice in a person with HypoCa?
Clue: ATI cramps
A person with HypoCa would have a positive what?
trousseau's and chvostek's signs
(jsut like HypoMg)
A person with HypoCa would have increase what? give 2 examples?
- GI motility
- hyperactive bowl sounds & diarrhea
A pt with HypoCa will have pathologic _______ and brittle ____.
When dealing with HypoCa you want to treat what?
When dealing with HypoCa you want to give oral or IV what?
When treating HypoCa why is it so important to treat the pts pain and anxiety?
to prevent hyperventilation-induced respiratory alkalosis