hey everyone it's sarah with registered nurse orient home and in this video i'm going to be going over hypercalcemia in the previous video I went over hypocalcemia and I'm going to be covering the causes of hypercalcemia the signs and symptoms the nursing interventions and I want to give you some new monix on how to remember all this stuff and I'm going to hit the highlights on things that you'll probably see on some exams by your professors and on the NCLEX exam now after you watch this lecture be sure to go to my website registered nurse Orion calm and take the free quiz that will test your knowledge on hypo and hyper Calci mia and you can access that in the description below or card should be popping up and you can take it from there okay first let's go over the basics of hypercalcemia I like to take these big words and dissect them because we need to know exactly what electrolyte we're talking about because we have a lot of hypo and hyper you have hyponatremia hyperkalemia and things like that so hyper means excess calcium and Mei means blood so we know that we're dealing with electrolyte of calcium and the meaning is there is too much calcium in the blood now what is a normal calcium level you definitely want to know this because a lot of times on tak-tek they're going to give you a number and you need to know if it's normal or not and a lot of times they will give you normal and you'll have to say that there's no nursing intervention because this is a normal level so you want to make sure that you know that it's eight point six to ten milligrams per deciliter and anything greater than ten is considered hypercalcemia now let's look at the role of calcium because in order to understand how it's affecting the body and why you're seeing these certain signs and symptoms you have to know how calcium normally works okay it plays a huge role in your bone in your teeth health and it plays a role in muscle and nerve formation and I mean function cell function and blood clotting now calcium is absorbed in your GI system so if you have any GI problems going on you can affect how much you will be able to absorb it we talked about in that and hypocalcemia it's stored in your bones so if you have messed up calcium levels you're definitely going to be at risk for bone fractures and it is excreted by your kiddin so your kidneys get rid of it so if you have some renal failure going on your kidneys may get rid of it too much of it or may just keep it so that can cause an issue and also as a side note you want to remember that vitamin D plays a huge role with calcium and absorbing it so anytime a patient's usually given like calcium supplements they may be given vitamin D because it's going to help absorb it and then you're going to see here in a second why if you take too much vitamin D it can increase your calcium levels and also phosphorus and calcium I like to think of this like a nursing school this is how I remembered it phosphorus and calcium they are sisters but they compete in everything and they don't like each other so they do the opposite so phosphorus and calcium are just like that they affect each other in opposite way so if false goes up calcium goes down if calcium goes up false goes down so remember that it's very important it will make sense while we're having these certain causes of hypercalcemia okay so what are the causes of it try to remember the word hi cow we're talking about high calcium so we have high cal each letter will represent a cause so H stands for hyperparathyroidism we talked about this in hypocalcemia but your parathyroid hormone plays a huge role in regulating your calcium and this is a huge thing that your exams love to hit on so remember if anything has to do with the parathyroid it has to deal with calcium as well so if you have hyperparathyroidism means you have a lot an excess of the parathyroid hormone this is going to cause calcium to be released too much in the blood so it's going to increase your levels of calcium i stands for increased intake of calcium this can happen when someone takes too much of their calcium helmut or too much vitamin d because remember vitamin D and calcium play a role together G stands for glucocorticoids and how they work is that they suppress the absorption of calcium so you're not absorbing the calcium and too much calcium is being left in the blood H for hyperthyroidism C for calcium excretion decrease with thought thigh-high diuretics I'm also renal failure and bone cancer because this is not allowing you to do to get rid of the calcium through the kidneys and a big thing you need to remember are the thiazide diuretics this is another big test question so like hydrochlorothiazide anything that ends in the thiazide diuretic can increase your calcium level so remember that a for adrenal insufficiency like in Addison's disease and L for lithium usage a lot of mental health patients are prescribed lithium and remember this this is another huge test question because how it works is it affects your parathyroid goes back up there and it can cause your phosphorus to decrease so what happens whenever false decreases calcium is going to increase so that is how lithium can affect that so try to remember that now how do these patients present with hypercalcemia what are their signs and symptoms remember the phrase the body is too weak weak being the key word because high calcium is going to make them feel horrible and terrible so W weakness of the muscles this is going to be very profound they're just going to be very lethargic tired and it's going to be really hard for them to move their muscles because remember calcium plays a role in muscle function e you're going to see some EKG changes especially if it's significantly high and normally what you're going to see the biggest thing is the shortened QT interval commit this to memory this is another important test question they're going to say patient has a calcium level of 12 what may you see on an EKG and the option would be shortened QT interval now remember in high Oh Cal Samia it's the opposite they actually have a prolonged QT interval and you can also see with hypercalcemia prolong st interval a a for absent reflexes they're not going to be as hyperactive like how they were in hypocalcemia they're going to be absent-minded disoriented they're also probably going to have abdominal distension from constipation the bowels are going to move slowly so they may have issues with that and then last the K for kidney stone formation another big test question and you'll see that here in a second with our nursing interventions how we're going to deal with this but they can have the renal calculi formation so you definitely want to watch out for that now let's look at the nursing interventions okay first thing you want to do is keep that patient hydrated this will help decrease the formation of any kidney stones next you'll want to watch out for safety such as any type of Falls or injuries because these patients are at risk for bone fractures you'll want to monitor their cardiac their GI renal and neuro status and put them on a heart monitor watch for any short and QT intervals anything like that and watch if the patient starts to complain of any flank or abdominal pain because this may be a sign that a kidney stone is for me and if I haven't you'll probably want to strain the urine to see if they've passed anything every time they void next you'll want to decrease their consumption of calcium rich foods and the doctor may stop them from taking if they were on any thiazide diuretics any calcium supplements or vitamin D and if you see that the patient is on that you may want to call the doctor to ask them what they want to do and the food you'll want to remember what foods are high in calcium because again this is another test question that professors like to hit on they'll say the calcium levels 12 what foods should the patient avoid so and I have thought of this little saying to help you remember because remember we have a calcium problem so here's a little sum saying young Sally's calcium serum continues to randomly mess up she can't keep that calcium level normal so the beginning letter of this phrase will correlate with the food so why for yogurt s for sardines C for cheese the other s for spinach the other C for collard greens T for tofu our for Ubar and M for milk those are your rich foods now these interventions is what you would do for mild cases now if you had a moderate case the doctor may order some type of calcium reabsorption inhibitor such as calcitonin that is a big one so remember that drug that is one of those in inhibits reabsorption of calcium and bio fosston aids remember false phosphorus and calcium do the opposite said they may order that to help decrease the calcium levels and prostaglandin synthesis inhibitors such as aspirin and in sets can help decrease the calcium level as well now in severe cases the patient will be ordered dialysis so Dallas's can pull off that excess of excessive and calcium now that is about a hypercalcemia now don't forget to go to my website register nurse re and calm and take that free quiz to test your knowledge on this and check out my other videos on electrolyte imbalances and please consider subscribing to this YouTube channel