CHAPTER 11 Fluids and Electrolytes^427
- Seizures due to irritation of nervous system tissue
- Cardiac arrhythmias due to increased excitation of cardiac muscle cells
- Prolonged QT interval will predispose to ventricular arrhythmias
- Contraction of facial muscle after tapping facial nerve anterior to ear
(Chvostek’s sign) due to increased excitation of nerve and muscle cells - Carpal spasm after inflation of blood pressure cuff to upper arm—occludes
brachial artery and applies pressure to nerves (Trousseau’s sign)
INTERPRETING TEST RESULTS
- Blood serum calcium level of less than 9 mg/dL.
TREATMENT
- Maintain intravenous access.
- High calcium diet to replenish lost calcium.
- Administer vitamin D if patient has deficiency; helps with absorption of
calcium:- ergocalciferol (vitamin D 2 )
- Administer calcium gluconate 10 percent IV (emergency treatment for seizure,
tetany, cardiac arrhythmia). - Administer calcium chloride (emergency treatment).
NURSING DIAGNOSES
- Imbalanced nutrition: less than what body requires
- At risk for injury
NURSING INTERVENTION
- Monitor vital signs for changes.
- Monitor intake and output.
- Monitor neurologic status for change, irritability, and disorientation.
- Monitor cardiovascular status for changes, irregularity of heartbeat, pulse
deficit (difference between heartbeat and peripheral pulse checked at the
same time), and cardiac rhythm.