Introduction[edit | edit source] Show
Nursing home, limited sun exposure. Hypocalcemia, a low blood calcium level, occurs when the concentration of free calcium ions in the blood falls below 4.4 mg/dL. [1][2] It can cause symptoms like tingling, muscle cramps, and heart arrhythmias, that can range from mild to life-threatening. Hypocalcemia is particularly a problem for people who are hospitalized or institutionalised.[3] Epidemiolgy[edit | edit source]Incidence and prevalence are difficult to estimate because hypocalcemia is a multifactorial diagnosis[4]. Hypocalcemia is particularly a problem for people who are hospitalized.[3]A 2018 study found 27.72% of inpatients had Hypocalcemia[5]. Etiology[edit | edit source]To maintain homeostasis, PTH regulates calcium levels in blood Chronic hypocalcemia is commonly due to inadequate levels of parathyroid hormone (PTH) or vitamin D (from food or limited sun exposure) or due to resistance to these hormones.[6] Low levels of PTH can be due to injury to the parathyroid gland from surgery or radiation treatment, autoimmune disease, or a genetic disease leading to low PTH. Other causes include:Medical conditions eg Celiac disease, pancreatitis, and kidney or liver disease; Certain medicines, eg diuretics, proton pump inhibitors, medicines to prevent seizures[3] Clinical Presentation[edit | edit source]Sometimes symptoms are relatively mild, other times they may cause life-threatening problems. In someone who is already critically ill, having hypocalcemia may increase a person’s risk of death.[3]
Diagnosis[edit | edit source]Involves
Treatment[edit | edit source]Treatment focuses on oral calcium and vitamin D supplements, as well as magnesium if deficiency is present. Treatment can be further intensified with thiazide diuretics, phosphate binders, and a low-salt and low-phosphorus diet when treating hypocalcemia secondary to hypoparathyroidism. Acute and life-threatening calcium deficit requires treatment with intravenous calcium.[6] Physiotherapy[edit | edit source]Due to the nature of hypocalcemia being secondary to a primary disease state, physical therapy management includes recognition of the signs and symptoms thereof. Appropriate action taken and appropriate referral. Case Reports/ Case Studies[edit | edit source]
References[edit | edit source]
Which should the nurse identify as a primary cause of hypocalcemia?The most common cause of hypocalcemia is hypoparathyroidism, which occurs when the body secretes a less-than-average amount of parathyroid hormone (PTH). Low PTH levels lead to low calcium levels in your body.
Which clinical manifestations should the nurse anticipate when assessing a patient who is diagnosed with hyponatremia?Lethargy is a clinical manifestation the nurse would anticipate for a patient diagnosed with hypernatremia. Seizures are a clinical manifestation the nurse would anticipate for a patient diagnosed with severe hypernatremia.
Which disease process would the nurse identify as the cause of a patient's serum potassium concentration of 5.3 mEq L?Hyperkalemia, defined as a serum potassium concentration greater than 5.0–5.3 mEq/L, is rare in a general population of healthy individuals. In hospitalized patients, the incidence of hyperkalemia has ranged from 1% to 10%, depending on how the condition is defined.
Which statement describes how sodium levels affect water balance in the body?Which statement describes how sodium levels affect water balance in the body? High sodium levels in the ECF pull water out of the cell. [If there are higher levels of sodium in the ECF, water will exit the cell to balance the amount of sodium in the ECF.]
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