Hypocalcemia - Lecture by Professor D

Intro

• Welcome back to Professor D's YouTube channel.
• Encouragement to watch the hypercalcemia video for comprehensive understanding.
• Instructions to like, subscribe, and hit the notification button for updates on future videos.
• Audio lessons available on the tutor's website: nexusnursinginstitute.com.
• Active on TikTok, Instagram, and Facebook.

Key Topics

Definition and Causes

• Hypocalcemia: Blood calcium level < 8.6 mg/dL (Low serum calcium).
• Hypocalcemia occurs due to conditions associated with parathyroid hormone deficiency.
• Multiple blood transfusions can result in hypocalcemia (citrate used as anticoagulant binds with calcium).

Nerve Excitability and Symptoms

• Increased nerve excitability in hypocalcemia.
  • Hypercalcemia: weak nerves and muscles.
  • Hypocalcemia: excited nerves and muscles.
• Sustained muscle contraction (tetany).
  • Key clinical manifestations: Chvostek's sign and Trousseau's sign.
  • Chvostek's sign: contraction of facial muscles when tapping over the facial nerve.
  • Trousseau's sign: carpal spasms when inflating blood pressure cuff.

Clinical Manifestations

• Clinical manifestations of tetany include:
  • Laryngeal stridor (medical emergency indicating airway closure).
  • Dysphagia, paresthesia, and numbness/tingling around the mouth/extremities.

Nursing Interventions

• Risk for Electrolyte Imbalance: Due to low calcium levels.
• Ineffective Breathing Pattern: Resulting from laryngeal stridor.
• Acute Pain: From constant muscle contraction.
• Risk for Injury: Due to potential seizures and tetany.
  • Potential complications: fractures, respiratory arrest from laryngeal stridor.

Treatment

• Mild or asymptomatic hypocalcemia:
  • High-calcium diet.
  • Vitamin D supplementation (needed for calcium absorption).
• Symptomatic hypocalcemia:
  • IV calcium gluconate.
  • CO2 retention measures (breathing into a paper bag, sedating the patient).
  • Switching from loop diuretics to thiazide diuretics (to reduce calcium excretion).
  • Closely monitor patients post-thyroid/neck surgery for hypocalcemia due to proximity to the parathyroid gland.

Summary

• Hypocalcemia involves numerous critical clinical signs which must be recognized.
• Patients post-thyroid or neck surgery need close monitoring for hypocalcemia signs due to proximity of surgery to parathyroid gland.
• Importance of an airway kit at patient’s bedside after thyroid surgery.
• Encouragement to study effectively and share the channel to support its growth.
• Available audio lessons and active social media engagement for further learning.