Lecture Notes: Hypocalcemia and Calcium Regulation

Introduction

• Hypocalcemia: Low calcium levels in the blood (
  • Defined as calcium less than 9.0 mg/dL
  • Key hormones regulating calcium:
    • Parathyroid Hormone (PTH): Increases calcium concentration in blood
    • Calcitonin: Decreases blood calcium by moving it into bones
    • Calcitrol: Inhibits calcitonin, releasing calcium into the bloodstream

Calcium Relationships

• Magnesium: Calcium's best friend; they often function together
• Phosphate: Calcium's arch-enemy; inversely related
  • High phosphate levels lead to low calcium and vice versa

Functions of Calcium

• Strong Bones, Blood, and Heartbeats (3 B's):
  • Bones: Structural integrity
  • Blood: Clotting factors
  • Beats: Heart rhythms

Causes of Hypocalcemia (LOCALI)

• L: Low Parathyroid Hormone (PTH)
  • Causes decrease in blood calcium levels
• O: Oral meds depleting calcium
  • Laxatives, loop diuretics, corticosteroids, anti-seizure medications
• C: Chronic diseases
  • Celiac, Crohn's, chronic kidney issues causing poor calcium absorption
• A: Antibiotics
  • Some antibiotics shift calcium into cells, lowering blood levels
• L: Low vitamin D or magnesium
  • Necessary for calcium absorption
• I: Increased phosphate levels
  • Reduces calcium levels due to their inverse relationship

Effects of Hypocalcemia

• Weak bones leading to fractures
• Weak blood leading to clotting issues
• Weak heartbeats causing dysrhythmias
• Overexcited lungs (laryngospasms), GI (diarrhea and cramping), and neurology (seizures, confusion)
• Key signs:
  • Trousseau's Sign: Arm spasms with blood pressure cuff
  • Chvostek's Sign: Facial twitching when touching temporal area

Nursing Interventions (FAST)

• F: Foods high in calcium (LSD):
  • L: Leafy greens
  • S: Sardines and tofu
  • D: Dairy products
• A: Administration of medications
  • Calcium acetate, IV/oral calcium with vitamin D
  • Calcium-containing antacids
• S: Safety precautions
  • Prevent falls, fractures, and bleeding
• T: Teaching patients
  • Encourage calcium boosters (magnesium, vitamin D) and avoid depleters (laxatives, diuretics)

Conclusion

• Importance of calcium balance for overall health
• Encouragement to continue learning through additional resources
• Thanks to the team and an invitation to subscribe for more content