Hypocalcemia Lecture Notes

Introduction

• Lecture by Registered Nurse Orion dot com
• Focus on hypocalcemia (previous video covered hypercalcemia)
• Will cover:
  • Signs and symptoms
  • Causes
  • Nursing interventions
  • Key points for exams and NCLEX
• Additional resource: Free quiz on hypocalcemia and hypercalcemia available on the website

Understanding Hypocalcemia

• Definition: Low calcium in the blood
  • Hypo: Low/beneath
  • Calci: Calcium
  • Emia: Blood
• Normal Calcium Level: 8.6 to 10 mg/dL
  • Hypocalcemia: Less than 8.6 mg/dL
• Role of Calcium:
  • Essential for bone and teeth health, muscle and nerve function, and blood clotting
  • Disruptions affect these body areas

Calcium Absorption and Excretion

• Absorption: Occurs in the GI system
  • Issues like Celiac or Crohn's disease can lead to low calcium
• Bone Storage: Low levels increase fracture risk
• Excretion: Via kidneys
  • Kidney issues can lead to excess calcium excretion
• Vitamin D: Aids in calcium absorption
  • Calcium and vitamin D supplementation often recommended
• Calcium and Phosphorus: Inverse relationship
  • High calcium = Low phosphorus and vice versa

Causes of Hypocalcemia

• Mnemonic: "LOW CALCIUM"
  • L: Low parathyroid hormone (e.g., post-neck surgery)
  • O: Oral intake inadequate (e.g., alcoholism, bulimia)
  • W: Wound drainage (especially GI)
  • C: Celiac/Crohn's disease (malabsorption issues)
  • A: Acute pancreatitis
  • L: Low vitamin D intake
  • C: Chronic kidney disease
  • I: Increased phosphorus level
  • U: Using medications (e.g., magnesium supplements, laxatives, diuretics)
  • M: Mobility issues

Signs and Symptoms

• Mnemonic: "CRAMPS"
  • C: Confusion
  • R: Reflexes hyperactive
  • A: Arrhythmias (prolonged QT intervals)
  • M: Muscle spasms (calf, feet), seizures
  • P: Positive Trousseau's sign
    • Blood pressure cuff test for hand flexing
  • S: Signs of Chvostek's
    • Facial nerve hyperexcitability test

Nursing Interventions

• Safety: Prevent fractures and monitor for laryngeal spasms
• IV Calcium Administration:
  • Use 10% calcium gluconate
  • Administer slowly, monitor heart rhythm, watch for infiltration
  • Preferably through a central line
  • Be cautious with patients on digoxin
• Oral Calcium and Vitamin D: Given with meals or bedtime
• Phosphorus Level Management: Use medications like Tums if phosphorus is high
• Diet: 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

Conclusion

• Don't forget to take the quiz on the website to test your knowledge
• Suggested further learning: Tutorials on fluid and electrolytes
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