CHAPTER 11 Fluids and Electrolytes^429
- Bradycardia later as electrical conduction is slowed
- Sinus arrest then cardiac arrest due to altered response of cardiac tissue to
normal stimuli - Shallow respirations due to skeletal muscle weakness
- Muscle weakness due to changes in neuromuscular response to normal stimuli
- Cardiac arrhythmias
- Nausea and vomiting due to decrease in peristaltic activity
- Constipation due to decrease in peristaltic activity
- Dehydration
- Kidney stones form as excess calcium deposits in kidneys; may be excreted
in urine
INTERPRETING TEST RESULTS
- Blood calcium level of greater than 10.5 mEq/L.
- Increased calcium level in urine.
- EKG shows shortened ST segment, widened T-waves.
TREATMENT
Medications are typically used to reduce calcium levels. When levels are highly
elevated or patients are having life-threatening problems, dialysis may also be uti-
lized to reduce calcium levels.
- Stop all calcium-containing medications (supplements, antacids).
- Monitor cardiac rhythm.
- Maintain intravenous access.
- Administer 0.9 percent normal saline solution to ensure adequate hydration
status; sodium aids in urinary excretion of calcium. - Administer Loop diuretics to enhance the excretion of calcium:
- furosemide
- Administer plicamycin, a calcium binder, to lower calcium levels.
- Administer calcitonin, phosphorus, bisphosphonates (etidronate, pamidronate
—to inhibit calcium resorption from the bone).