Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
What are the benefits of having the proper amount of Ca in your diet (800-1,000mg for adults)?
|
increases bone strength and density,
aids in skeletal and cardiac muscle contraction, transmits nerve impulses, helps form clots |
|
|
How does albumin interact with Calcium?
|
A protein (like) albumin binds with Ca in the body
|
|
|
If there is an decrease in amount of albumin in the body what implication does this have for Ca levels in the body?
|
Ca levels will be low as well
|
|
|
What two elements form compose youre teeth and bones
|
phosphoruous and calcium
|
|
|
About ____% of Ca in body that is not in bones and teeth(___% of all Ca in body) is bound to albumin
|
50%
90% |
|
|
the normal range of serum Ca in body is?
|
8.9 -10.1mg/dL
|
|
|
the normal range of free Ca in body is?
|
4.5- 5.1mg/dL
|
|
|
What are the S/S of HYPOcalcemia?
|
confusion, irritability, anxiety
parastesia in toes fingers and face muscle twitches, spasms, and tetany decreased BP, arrythmias, and ECG changes altered blood clotting + Chvostek (head tapping elicits an ipsilateral grimace) + Trousseau (BP cuff 4 minutes elicits an ipsilateral wrist flex) |
|
|
What happens with regards to the release of parathyroid hormone when Ca levels are low?
How will the release of parathyroid hormone affect serum Ca levels? What happens when Ca levels are high with regards to parathyroid hormone? |
Parathyroid is released and draws out Ca from bones into plasma. then at the same time promotes absoprtion of Ca into bones (increased absorption in the kidneys and intestines)
increase supress parathyroid hormone if Ca levels are high |
|
|
When Ca levels are high what hormone is activated?
What does this hormone promote decreased serum Ca levels? What role does Vit D play in Ca |
Calcitonin
It inhibits vit D activation and tells kidneys to excrete calcium and trys to keep Ca in bone so there is no more relesae into plasma. It tells intestines to absorb Ca |
|
|
What demographics are at risk of hypocalcemia?
|
The number one cause is decreased parathyroid function. Low Magnesium levels can affect parathyroid function and effect calcium levels.
many asians and blacks are lactose intolerant Alcoholics typically have poor nutrition and low calcium levels. Breast fed infants if mom does not take in enough. Elderly if they have a poor diet. Recent ortho surgery or bone healing (will need more) You may also see this with malignancies or the administration of lots of blood products. |
|
|
What is Ca relation to Na in the body?
|
Ca decreases Na movement so its an indirect relationship. When Ca increases Na movement decreases and vice versa.
|
|
|
Impaired absorption of Ca can be attributed to
|
severe diarrhea, laxative abuse, lack of vit D,
|
|
|
How do you treat acute Hypocalcemia?
|
Administer Calcium IV
IV push is an option but it must be done slowly so as not to shock the heart. |
|
|
How do you treat a chronic case of Hypocalcemia?
|
Administer oral Ca
30 min prior administer some food high in Vitamin D or the vitamin itself to promote absorption of the Ca |
|
|
What precuastions need to be taken when adminstering Ca treatment for Hypocalcemia?
|
provide a bed with padded rails (due to increased risk of seizure)
oxygena and suction at bedside ( |
|
|
A loss of Ca will increase or decrease clotting times?
|
increase
|
|
|
What are some foods high in calcium?
|
broccoli, spinach, fish, milk, nuts and other dairy products
|
|
|
Why is it important to monitor the IV site where Ca administration is being given?
|
extravasation of calcium chloride or glucinate will irritate surrounding tissues and can cause necrosis.
|
|
|
What is the number 1 of hypercalcemia?
|
The parathyroid hormone is secreted more than normal and this causes Ca to be pulled from bone and into the plasma and the kidneys are told to hold onto Ca.
In certain types of cancers (breast and lung) the cancer invades bone and exudes a hormone similar to that of parathyroid in function in that it tells the bone to release Ca. As a result the kidneys cannot excrete the Ca fast enough. |
|
|
What are some of the S/S of hypercalcemia?
|
increased HR followed by slowing as the Ca elevates and bradycardia sets in as the BP increases= hypertension
fractures (can occur spontaneously) personality changes, confusion, depression Hypoactive bowel sounds renal calculi (causes flank pain in lower back) polyuria, polydipsia, lethargy, drowsiness, coma, apathy, coma, decreased DTR's, muscle weakness clots |
|
|
What treatment modalities are instituted for treating hypercalcemia?
|
Stop calcium solution administration or intake
weight bearing activities Lasix (loop diuretic) with a loop the Na will follow the Ca and could cause hyponatremia) this is why Normal Saline should also be administered to the patient to replenish Na lost. Minimize patient confusion as it may lead to more falling ambulation will help stop release of Ca from the bone Maintain a safe environment Monitor the cardiac function for dysrythmias and decreased CO. Strain urine for calculi if they have flank pain. |
|
|
Magnesium levels are regulated by what organ?
|
the kidneys
|
|
|
What are magnesium imbalances often misinterpreted as?
Why? |
Ca or K imbalances
|
|
|
What is a normal serum Mg range?
|
1.5 - 2.5 mEq/L
|
|
|
What percentage of Mg is in bone?
in ECF? remainder is muscle and soft tissue bound to protein? free plasma? |
60%
1% 2/3 of 39% 1/3 of 39% |
|
|
Where do we get Mg and how do we lose it?
|
Food intake
lost through stool and urine " the good ol' fashioned way" |
|
|
What is the function of Mg in our bodies?
|
vasodilation (increases blood flow particularly to the heart)
helps produce ATP aids in carbohydrate metabolism helps move Ca and K across cell membranes cofactor in clotting cascade helps in cardiac and skeletal muscle contraction |
|
|
How common is Hypomagnesemia in hospital patients? Because only 1 % of Mg is in the ECF people can have a deficiency even when there is a normal serum level.
|
about 10% of them have Mg deficiency
|
|
|
How do patients lose their Mg stores and render themselves deficient?
|
Chronic Alcoholism
Malabsorption: with use of loop or thiazide diuretics, IBS, or bowel resection. Starvation Uncontrolled diabetes mellitus: glucose moves into the cell and pushes Mg then it is excreted. Renal diseases Pancreatitis, Vomiting, or NG suction. |
|
|
What are some of the S/S of hypomagnesemia?
|
hypocaclcemia (similarities): confusion, irritability, seizures, tetany
parastesias, + Trousseau ,+ Chvostek's sign, dysrythmias, hypercalcemia (like): nausea, vomiting, contstipation, HTN hypercalcemia (contrast):hyperactive DTR's (UNLIKE hypo or hyper calcemia): delusions, insomnia |
|
|
How do you treat hypomagnesemia?
|
stop loop diuretics if on them
administer MgSO4 diluted and slowly through IV ideally. BUT carefully DO NOT administer IM because it will cause tissue damage dietary intake (foods high in Mg include leafy green vegetables, whole grains, and nuts) |
|
|
What should be monitored in treatement of a patient with Hypomagnesemia?
Patient teaching points? |
monitor the pt's cardiac and neuro status, dietary intake, Assess DTR's every 1hour
use of antacids and laxatives should can be used to raise levels because most contain magnesium diuretics should be monitored if used teaach about the above monitoring as well and what is an emergency (low vitals etc.) |
|
|
What are some of the common causes of Hypermagnesemia?
|
chronic renal failure or insufficiency, addison's disease (adrenal insufficiency in producing proper amounts of steriod hormones), excessive intake (through antacids,laxatives, Hemodyalisis with Mg rich component, IV Mg replacement, or food) , dehydration, untreated diabetic ketoacidosis.
|
|
|
What are the S/S of Hypermagnesemia?
|
stand alone's: feeling of warmth and sweating, cardiac arrest, hypotension,
like hypercalcemia: decreased DTR, muscle weakness, bradycardia (2nd), depression, lethargy, drowsiness, coma, depression, |
|
|
How do you treat Hypermagnesemia?
|
If renal function is normal, we give IV fluids to increase urine output and the ability to excrete Mg
Loop (lasix) to excreat Mg Give Ca to reverse cardiac effects of hypermagnesemia (it will increase improve contractility of the heart and restore a better BP) -- IV calcium gluconate monitor cardiac and respiratory status avoid giving antacids or laxatives Watch respiratory status, because if it becomes depressed, patient’s may need mechanical ventilation. Limit meats, nuts, beans, fish, veggies, whole grains. monitor I and O |
|
|
Pt teaching for treatment of Hypermagnesemia?
|
lay off the antacids and laxatives
Watch intake of Mg rich foods (meat, nuts, fish, leafy vegetables, beans, and whole grains) |
