Card Set Information
AMS1T2 Calcium Imbalances
General info about Ca
Primary source is from ingested foods
>99% combined w/PO
& concentrated in skeletal system
Inverse relationship w/PO
Bones provide readily available store of Ca
Controlled by PTH, calcitonin, vitamin D
Normal 8.5-11 mg/dL
What are the functions of Ca
Blocks sodium Na+ transport & stabilizes cell membrane
Transmission of nerve impulses
Contraction of muscle (including myocardium)
Aids in blood clotting
Aids in formation of teeth & bone
Only the ionized form is biologically active
What is the pathophys of hyperCa
Hyperparathyroidism--Parathyroid-->PTH-->release of Ca
from bone into blood stream (resorption) and ^ reabsorption of Ca
in the GI and renal tubules.
Malignant cancer-->destruction of bone and release of calcium into BS.
release into blood stream from bones.
Hypophosphatemia due to inverse relationship between PO4 and Ca2+ levels.
Excess vit D-->^reabsorption of Ca
Acidosis (increases ionized Ca
). Decreases binding of Ca
with albumine to ^ levels of biolgically active Ca
SnSs of hyperCa
Decreased memory, confusion, disorientation
Bone pain and fractures
Irritability of cardiac muscle
Renal calculi w/renal impairment
What are some nursing interventions for pt w/hyperCa
Administer loop diuretic (ie Lasix) to eliminate via urine
. Due to inverse relationship with Ca
increasing one will decrease the other.
Hydration w/isotonic saline infusion
Mobilization with weight bearing exercise to encourage Ca
reabsorption into bones.
Increase hydration to 3-4L water/day to eliminate excess Ca
and to avoid producing kidney stones.
What are the common pathologies of hypoCa
Decreased production of PTH, ie due to partial removal of the thyroid gland.
Acute pancreatitis-->lipolysis-->^binding of Ca2+ to fatty acids--> v levels of biologically active Ca
Multiple blood transfusions due to addition of citrate (anticoagulant) during transfution. Ca2+ binds to citrate--> v levels of biologically active Ca
Alkalosis. ^pH-->^binding of Ca
SnSs of hypoCa
: dorsaflexion of hand with BP cuff for a few minutes.
: tetany of face with mild finger poke to cheek.
numbness & tingling around the mouth or extremities
What are some nursing intervensions for the pt w/hypoCa
Oral or IV supplements
Tx pain or anxiety to prevent hyperventilation-induced respiratory alkalosis-->hypoCa