Hypercalcemia Lecture Notes

Introduction to Hypercalcemia

• Definition: High calcium levels in the blood (hyper means high, cal refers to calcium, emia means in the blood).
• Normal Range: Calcium levels more than 10.5 mg/dL.

Functions of Calcium

• 3Bs:
  • Bones: Calcium keeps bones strong.
  • Blood: Clotting factors are strengthened.
  • Beats: Refers to heartbeats being regulated.

Hormonal Regulation

1. Parathyroid Hormone (PTH): Increases blood calcium levels.
2. Calcitonin: Decreases blood calcium, deposits calcium into bones.
3. Calcitrol: Inhibits calcitonin, releases calcium into the blood.

Fun Facts

• BFF: Magnesium; helps when magnesium is low.
• Enemy: Phosphate; inverse relationship with calcium levels.

Causes of Hypercalcemia

• Acronym - HAM:
  • H: Hyperparathyroidism (increases calcium).
  • A: Anti-acids containing calcium (like Tums).
  • M: Malignant cancer cells (release excess calcium).
• Low Phosphate: Leads to high calcium.

Effects of Hypercalcemia

• Body Effects: Swollen and slow functions.
• Cardiac Effects:
  • Decreased heart rate, respiratory rate, and blood pressure.
  • EKG Changes: Heart blocks, shortened QT waves, wide T waves.
  • Spastic contraction of heart muscles.
• Respiratory Effects: Shortness of breath, weak respirations.
• GI Effects: Constipation, nausea, vomiting.
• GU Effects: Kidney stones (renal calculi).
• Neurological Effects: ALOC (altered level of consciousness), decreased DTRs (deep tendon reflexes).
• Muscle Effects: Decreased excitability, severe cases lead to muscle weakness.
• Bone Pain: Indicates calcium taken from bones.

Nursing Interventions (SLIMFAST)

• S: Safety from falls (fall precautions).
• L: Lasix (furosemide) or loop diuretics to excrete calcium.
• I: IV phosphate to decrease calcium.
• M: Monitor EKG, I&O (input and output), and kidney stones.
• F: Fluids (normal saline) to dilute blood and prevent renal stones.
• A: Avoid high calcium foods (LSD - Leafy greens, Sardines, Dairy).
• S: Serious cases require dialysis.
• T: Treatment with calcium reabsorption inhibitors (calcitonin, biphosphates, aspirin, NSAIDs).

Conclusion

• Understand the importance of calcium regulation and management of hypercalcemia for patient health.