Medical-surgical Nursing Demystified

(^428) Medical-Surgical Nursing Demystified

• Monitor for signs of hypercalcemia when administering medication (can over-
  medicate with calcium):
  
  
  • nausea
  
  
  • vomiting
  
  
  • anorexia
  
  
  
  


• Explain to the patient:
  
  
  • Avoid dependence on laxatives—these medications can alter bowel pat-
    terns, causing altered absorption and excess elimination of calcium and
    other electrolytes.
  
  
  • Avoid dependence or overuse of antacids—these medications cause excess
    intake of calcium (or other electrolytes, depending on composition).
  
  
  
  

Hypercalcemia

WHAT WENT WRONG?

Hypercalcemia is an abnormally high amount of calcium in the blood. Excess

intake of calcium (such as supplements or antacids) or altered excretion of calcium

(such as in patients with renal failure or those taking thiazide diuretics) may cause

hypercalcemia. Patients may also develop elevated calcium levels with prolonged

immobility, glucocorticoid use, hyperthyroidism, hyperparathyroidism, lithium

use, dehydration, or malignancies with metastasis to the bone.

PROGNOSIS

Correction of the calcium level is necessary to control the signs and symptoms.

Correction or management of the underlying disorder is necessary to correct the

abnormal calcium level. High calcium levels cause altered excitability of heart, skele-

tal, and smooth muscle tissues of the gastrointestinal tract, and nervous tissues.

HALLMARK SIGNS AND SYMPTOMS

• Increased heart rate initially


• Bounding peripheral pulses

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