calcium
Content
HYPOCALCEMIA
Occurs when calcium levels fall
below normal range.
When total serum calcium level
fall below 4.5 mEq/L.
PATHOPHYSIOLOGY of
PRECIPITATING FACTORS
HYPOCALCEMIA
Inadequate calcium intake.
PREDISPOSING
FACTORS
Age
Impaired calcium absorption
Excessive calcium loss
Renal Failure
Pancreatitis
Acidosis
Disease of parathyroid gland
Pathophysiology
SKELETAL
Irritability of
smooth
muscle
Muscle
spasm,
Calcium or Vit. D intake or
absorption decreases or
calcium excretion increases.
Parathyroid gland
releases PTH
NEUROMUSCUL
AR
Increased
neuromuscul
ar extability
Nunbness
and tinglling
of the hands
PTH draws calcium from bone and
promotes renal reabsorption and intestinal
absorption of calcium
“Signs and
symptoms”
NEUROLOGIC
Confusions
Depression
Memory
loss
NEUROMUSC
ULAR
Numbness
Muscle
Cramps
Trousseau’s
sign
Chvotek’s
sign
Lack of calcium
outstrips PTH’s ability
to compensate.
Calcium is no longer
able to maintain cell
structure and function.
HYPOCALCEMI
A
“Signs and
symptoms”
CARDIOVASCU
LAR
Myocardial
contractility
w/ reduction of
cardiac output
ECG:
prolonged QT
interval
Arrhythmias
Nursing Diagnosis:
Imbalanced Nutrition Less than
Body Requirements R/T inadequate
intake of Calcium and Vitamin D.
NURSING MANAGEMENT
•Monitor Vital signs
•Assess Patient for Trousseau’s and
Chvostek’s sign in high risk clients.
•Assess also for bleeding in the gums and
petechiae in the skin.
• Monitor IV sites for infiltration or phlebitis
when IV calcium is infused.
• Assist in moving or turning client .
•Encourage client to eat foods that are rich
in
calcium.
•MEDICAL
MANAGEMENT
• CALCIUM SUPPLEMENTS
•VITAMIN D SUPPLEMENTS
NURSING DIAGNOSIS
Risk for trauma related to
demineralization of bone
resulting in pathologic
NURSING
MANAGEMENT
fractures
.
•Monitor plasma calcium level.
• Use caution by obtaining adequate help to
turn or move the client.
•Keep client’s bed in low position and use
side rails.
•Use gait belts and assistance to walk or
transfer the patient to and from bed.
NURSING
DIAGNOSIS
Impaired Gas
exchange related
to laryngeal
spasm.
NURSING MANAGEMENT
•Auscultation of chest.
•Note rate and depth of respirations, and type of
breathing pattern.
•Asses for laryngeal stridor.
•Inform Patient that temporary hoarseness and
voice weakness may occur
Occurs when calcium levels fall
below normal range.
When total serum calcium level
fall below 4.5 mEq/L.
PATHOPHYSIOLOGY of
PRECIPITATING FACTORS
HYPOCALCEMIA
Inadequate calcium intake.
PREDISPOSING
FACTORS
Age
Impaired calcium absorption
Excessive calcium loss
Renal Failure
Pancreatitis
Acidosis
Disease of parathyroid gland
Pathophysiology
SKELETAL
Irritability of
smooth
muscle
Muscle
spasm,
Calcium or Vit. D intake or
absorption decreases or
calcium excretion increases.
Parathyroid gland
releases PTH
NEUROMUSCUL
AR
Increased
neuromuscul
ar extability
Nunbness
and tinglling
of the hands
PTH draws calcium from bone and
promotes renal reabsorption and intestinal
absorption of calcium
“Signs and
symptoms”
NEUROLOGIC
Confusions
Depression
Memory
loss
NEUROMUSC
ULAR
Numbness
Muscle
Cramps
Trousseau’s
sign
Chvotek’s
sign
Lack of calcium
outstrips PTH’s ability
to compensate.
Calcium is no longer
able to maintain cell
structure and function.
HYPOCALCEMI
A
“Signs and
symptoms”
CARDIOVASCU
LAR
Myocardial
contractility
w/ reduction of
cardiac output
ECG:
prolonged QT
interval
Arrhythmias
Nursing Diagnosis:
Imbalanced Nutrition Less than
Body Requirements R/T inadequate
intake of Calcium and Vitamin D.
NURSING MANAGEMENT
•Monitor Vital signs
•Assess Patient for Trousseau’s and
Chvostek’s sign in high risk clients.
•Assess also for bleeding in the gums and
petechiae in the skin.
• Monitor IV sites for infiltration or phlebitis
when IV calcium is infused.
• Assist in moving or turning client .
•Encourage client to eat foods that are rich
in
calcium.
•MEDICAL
MANAGEMENT
• CALCIUM SUPPLEMENTS
•VITAMIN D SUPPLEMENTS
NURSING DIAGNOSIS
Risk for trauma related to
demineralization of bone
resulting in pathologic
NURSING
MANAGEMENT
fractures
.
•Monitor plasma calcium level.
• Use caution by obtaining adequate help to
turn or move the client.
•Keep client’s bed in low position and use
side rails.
•Use gait belts and assistance to walk or
transfer the patient to and from bed.
NURSING
DIAGNOSIS
Impaired Gas
exchange related
to laryngeal
spasm.
NURSING MANAGEMENT
•Auscultation of chest.
•Note rate and depth of respirations, and type of
breathing pattern.
•Asses for laryngeal stridor.
•Inform Patient that temporary hoarseness and
voice weakness may occur
