Medical-surgical Nursing Demystified

(Sean Pound) #1

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
    β€”to inhibit calcium resorption from the bone).

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