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Monday, February 2, 2015

Hypercalcemia: Signs & Symptoms, Causes, Treatments

Hypercalcemia, excess calcium, nursing school, nurse, RN, electrolytes, imbalances, cancer, hyperparathyroidism

Overview of Hypercalcemia

Hypercalcemia is an excess of calcium in the extracellular space. If it is allowed to become severe it has a significant morbidity and mortality rate. Normal calcium serum levels are 8.9 - 10.3 mg/dL. When the serum levels are greater than 10.3 mg/dL is referred to as hypercalcemia.
It's important to read this post (at least the clinical manifestations) so you recognize when a patient is experiencing hypercalcemia.


Causes

Hyperparathyroidism and Malignancies account for almost all cases of hypercalcemia.
  • Primary Hyperparathyroidism- Increases production of PTH. PTH transfers calcium from bone to blood plasma (in a nut shell) so that's the cause of the increased calcium in the blood stream.
  • Malignancies- Mostly lung and breast cancer and typically when the cancer is becoming more severe.
  • Prolonged Immobilization- Look out for in your patients with spinal cord injuries.
  • Drugs- Thiazide Diuretics, Lithium, and large doses of: calcium supplements, vitamin A, and vitamin B.

Symptoms / Clinical Manifestations


  • Muscle Weakness- serum levels between 11.5 - 13 mg/dL.
  • Decreased Deep-Tendon Reflexes- because there is a reduction in neuromuscular excitability.
  • Polyuria- can also develop kidney stones. Calcium salt deposits in the kidneys can lead to kidney failure.
  • Constipation- the excess calcium slows down the motility in the GI tract.
  • Anorexia- serum levels between 11.5 - 13 mg/dL.
  • Nausea/Vomiting- serum levels between 11.5 - 13 mg/dL.
  • Confusion
  • Arrhythmia
  • Heart Block
  • Shortened QT Interval
  • Hypertension

Treatment


Like I've mentioned in my other posts on electrolytes, treatment should be driven by the cause of the imbalance. 

  • Parathyroidectomy- Since hyperparathyroidism is one of the most common causes of hypercalcemia, you would have to take out all or partial parts of the parathyroid.
  • Cancer Treatment- if the hypercalcemia is caused by a malignancy, then you would need to treat that tumor.
  • Increase Fluid Intake
  • Encourage Mobility


Of course this isn't extensive list of all the causes and treatments of hypercalcemia. This is to help you get the jist of the imbalance.

You may also want to check out my posts on:

I hope that helps your understanding.

Is there a subject you'd like for me to post about? Leave a comment below or email me at nurse.nightingale13@gmail.com

Xoxo,

Nightingale

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