Lecture: Hypercalcemia

Introduction

• Presented by Sarah from Registered Nurse Orient Home
• Focus: Hypercalcemia
• Previous lecture: Hypocalcemia
• Topics covered:
  • Causes
  • Signs and symptoms
  • Nursing interventions
  • Mnemonics for memorization
  • Exam highlights (professor exams, NCLEX)

Basics of Hypercalcemia

• Dissecting the term:
  • "Hyper" = excess
  • "Calcemia" = calcium in the blood
• Normal calcium levels: 8.6 to 10 mg/dL
• Hypercalcemia: >10 mg/dL

Role of Calcium in the Body

• Important for:
  • Bone and teeth health
  • Muscle and nerve function
  • Cell function
  • Blood clotting
• Absorption in the GI system
• Storage in bones
• Excretion by kidneys
• Vitamin D supports calcium absorption
• Phosphorus and calcium have an inverse relationship

Causes of Hypercalcemia (Mnemonic: "HI CAL")

1. H: Hyperparathyroidism
   • Excess parathyroid hormone releases more calcium into blood
2. I: Increased intake of calcium
   • Through supplements or excessive vitamin D
3. G: Glucocorticoids
   • Suppress calcium absorption
4. H: Hyperthyroidism
5. C: Calcium excretion decrease
   • Thiazide diuretics, renal failure, bone cancer
6. A: Adrenal insufficiency (e.g., Addison's disease)
7. L: Lithium usage
   • Affects parathyroid and phosphorus levels

Signs and Symptoms (Mnemonic: "The Body is Too WEAK")

• W: Weakness of muscles
• E: EKG changes (shortened QT interval)
• A: Absent reflexes and disorientation
• K: Kidney stone formation

Nursing Interventions

• Hydration to prevent kidney stones
• Safety precautions due to fracture risk
• Monitor:
  • Cardiac, GI, renal, neuro status
  • Heart monitor for QT interval issues
  • Flank or abdominal pain for kidney stones
  • Strain urine for stones
• Dietary adjustments:
  • Reduce calcium-rich foods
  • Possible medication adjustments (thiazide diuretics, supplements)

High Calcium 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

Treatment for Moderate and Severe Cases

• Moderate:
  • Calcium reabsorption inhibitors (e.g., calcitonin)
  • Bisphosphonates
  • Prostaglandin synthesis inhibitors (aspirin, NSAIDs)
• Severe:
  • Dialysis to remove excess calcium

Conclusion

• Visit website for a quiz and more information
• Reminder to explore other electrolyte imbalance videos
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