Understanding Hypercalcemia: Causes and Care

Sep 9, 2024

Hypercalcemia Lecture Notes

Introduction

  • Presenter: Sarah from Registered Nurse RN
  • Focus: Hypercalcemia
    • Previous video covered hypocalcemia
  • Key topics:
    • Causes
    • Signs and Symptoms
    • Nursing Interventions
    • Mnemonics
    • Exam highlights (NCLEX)

Basics of Hypercalcemia

  • Definition: Excessive calcium in the blood
  • Normal Calcium Levels: 8.6 to 10 mg/dL
    • Levels > 10 indicate hypercalcemia

Role of Calcium

  • Functions:
    • Bone and teeth health
    • Muscle and nerve function
    • Cell function and blood clotting
  • Absorption and Excretion:
    • Absorbed in the GI system
    • Stored in bones
    • Excreted by kidneys
  • Vitamin D: Helps in absorption of calcium
  • Phosphorus Relationship: Inversely related to calcium
    • When phosphorus increases, calcium decreases and vice versa

Causes of Hypercalcemia

  • Mnemonic: "HI CAL"
    • H: Hyperparathyroidism
    • I: Increased intake of calcium/vitamin D
    • G: Glucocorticoids suppress calcium absorption
    • H: Hyperthyroidism
    • C: Calcium excretion decreased (thiazide diuretics, renal failure, bone cancer)
    • A: Adrenal insufficiency (Addison's disease)
    • L: Lithium usage

Signs and Symptoms

  • Mnemonic: "The body is too WEAK"
    • W: Weakness of muscles
    • E: EKG changes (shortened QT interval)
    • A: Absent reflexes, disorientation, abdominal distension
    • K: Kidney stone formation

Nursing Interventions

  1. Hydration: Prevent kidney stones
  2. Safety: Prevent falls and fractures
  3. Monitoring:
    • Cardiac, GI, renal, and neuro status
    • EKG for shortened QT intervals
    • Flank or abdominal pain for kidney stones
  4. Dietary Changes:
    • Reduce calcium-rich foods (use mnemonic: "Young Sally's Calcium Serum Continues To Randomly Mess Up")
      • Yogurt, Sardines, Cheese, Spinach, Collard greens, Tofu, Rhubarb, Milk
  5. Medication Adjustments:
    • Consider stopping thiazide diuretics, calcium supplements, vitamin D
  6. Moderate Cases:
    • Drugs: Calcitonin, bisphosphonates, prostaglandin synthesis inhibitors
  7. Severe Cases:
    • Dialysis

Conclusion

  • Visit Registered Nurse RN website for a quiz
  • Check out other videos on electrolyte imbalances
  • Subscribe to the YouTube channel for more content