[Fundamentals] Electrolyte imbalances: Hypocalcemia

Pathophysiology

 

Decreased serum calcium level (<9mg/dL [2.25 mmol/L])

 

Causes:

-Low parathyroid hormone (PTH) levels : Parathyroidectomy, thyroidectomy, radical neck surgery

-Vitamin D deficiency

-intestinal malabsorption (celiac)

-phosphate-binding calcium: Chronic Kidney disease, Tumor lysis syndrome

 

Clinical Features

-Calcium acts like a sedative -> nerves and muscles are irritable when levels are low.

* Peripheral neuromuscular excitability (tetany)

:chvostek sign -early symptom: tapping on the fafial nerve -> 그쪽 안면이 흔들림

:trousseau sign - 3분동안 압박 주면 carpal spasm 되면서 손이 안으로 꼬여 들어감

:Paresthesia (tingling of lips and fingres)

:hyperreflexia (3+)

:muscle cramps

:sezures

:cardiac dysrhythsmias

:Severe hypocalcemia -> life-threatening respiratory depression and laryngeal stridor.

 

NRS interventions

-monitor serum calcium levels

-IV calcium gluconate/chloride

-seizure precautions

-ECG

-respiratory status: rate, quality, and pattern of respirations

-increase calcium-rich food.

Don't Let Fish And Tofu Spoil

Dairy, Leafy greens, Fish정어리와 연어, Almonds, Tofu, Soy profucts.