Hypocalcemia Overview

Definition and Normal Levels

• Hypocalcemia: Low calcium levels in the blood
  • Hypo: Low
  • Calsy: Calcium
  • Emia: Blood
• Normal Calcium Levels: 8.6 to 10 mg/dL
  • Below 8.6 mg/dL is considered hypocalcemia
• some hospitals say 8.5-10.1

Role of Calcium in the Body

• Essential for:
  • Bone and teeth health
  • Muscle function
  • Nerve cell function
  • Blood clotting
• Calcium Absorption and Excretion:
  • Absorbed in the GI system
  • Stored in bones
  • Excreted by kidneys
• Vitamin D: Facilitates calcium absorption
• Calcium and Phosphorus: Inversely related; as one rises, the other falls

Causes of Hypocalcemia

• Mnemonic: LOW CALCIUM
  • L: Low parathyroid hormone
    • Due to destruction, removal, or neck surgery
  • O: Oral intake inadequate (e.g., alcoholism, bulimia)
  • W: Wound drainage, especially GI
  • C: Celiac and Crohn's diseases
  • A: Acute pancreatitis
  • L: Low vitamin D intake
  • C: Chronic kidney disease
  • I: Increased phosphorus levels
  • U: Using certain medications (e.g., magnesium supplements, laxatives)
  • M: Mobility issues

Signs and Symptoms

• Mnemonic: CRAMPS
  • C: Confusion
  • R: Reflexes hyperactive
  • A: Arrhythmias (prolonged QT interval)
  • M: Muscle spasms, seizures
  • P: Positive Trousseau's sign
    • Blood pressure cuff test
  • S: Positive Chvostek's sign
    • Facial nerve excitability test

Nursing Interventions

• Safety: Prevent bone fractures, monitor for laryngeal spasms
• Administer IV Calcium: 10% calcium gluconate
  • Given slowly, monitor heart rhythm, watch for infiltration or phlebitis
• Oral Calcium and Vitamin D Supplements: After meals or at bedtime
• Phosphorus Management: If high, treat to allow calcium levels to rise
• Encourage Calcium-Rich Foods:
  • Mnemonic: Young Sally's Calcium Serum Continues to Randomly Mess up
    • Y: Yogurt
    • S: Sardines
    • C: Cheese
    • S: Spinach
    • C: Collard greens
    • T: Tofu
    • R: Rhubarb
    • M: Milk