NURS 624 Electrolyte Imbalance Exam
questions and answers
Normal Calcium range Serum vs Ionized - ✅✅Serum 8.6-10.2 mg/dl
Ionized 4.6-5.3 mg/dl
Causes of hypocalcemia include: - ✅✅-Hypoparathyroidism (usually from surgery)
-Hypomagnesemia
-Pancreatitis (acute)
-Vitamin D Deficiency
-Chronic ETOH
-Acute Tumor Lysis Syndrome
-Rhabdomyolysis
-Massive blood Transfusion
-Medications (phenytoin, cisplatin, or estrogen)
Subjective findings of Hypocalcemia: - ✅✅-Mental changes: Confusion, anxiety, depression.
-Extrapyramidal changes: tremors, ataxia, dystonia
-Tetany(involuntary contraction of muscles)
-Seizures
-Weakness
Chvostek's sign - ✅✅Facial twitch with tapping ipsilateral facial nerve (hypocalcemia)
Trousseau's sign - ✅✅Carpal spasm on inflation of BP cuff (hypocalcemia)
Hypocalcemia Physical exam findings - ✅✅Proximal Muscle weakness- hyperactive deep tendon
reflexes,
dry skin, brittle hair, brittle nails
, Normal Serum albumin - ✅✅3.5-4.6 g/dl (used to correct calcium)
normal serum magnesium - ✅✅1.5-2.5 mg/dL
In hypocalcemia what will you see in an EKG? - ✅✅-Prolonged QTc interval
Nonspecific T wave changes
Hypocalcemia management in symptomatic acute patients - ✅✅-calcium chloride(IV)
-Calcium gluconate(IV)
-Follow with 1g/hr calcium gluconate over 3 hours(IV)
Hypocalcemia management in asymptomatic chronic patients - ✅✅-Calcium carbonate or other
calcium salt
-Vitamin D or preparations (to help absorb calcium)
Causes of Hypercalcemia - ✅✅-Hyperparathyroidism (most common)
-Malignancy
-Vitamin D excess
-Vitamin A intoxication
-Hyperthyroidism
-Immobilization
-Thiazide diuretic therapy
Hypercalcemia subjective findings: - ✅✅-Neuro: Lethargic, depression, personality changes
-GI: N/V, constipation
-MSK: proximal muscle weakness, bone pain
-Renal: polyuria/nocturia, renal colic (stones)
questions and answers
Normal Calcium range Serum vs Ionized - ✅✅Serum 8.6-10.2 mg/dl
Ionized 4.6-5.3 mg/dl
Causes of hypocalcemia include: - ✅✅-Hypoparathyroidism (usually from surgery)
-Hypomagnesemia
-Pancreatitis (acute)
-Vitamin D Deficiency
-Chronic ETOH
-Acute Tumor Lysis Syndrome
-Rhabdomyolysis
-Massive blood Transfusion
-Medications (phenytoin, cisplatin, or estrogen)
Subjective findings of Hypocalcemia: - ✅✅-Mental changes: Confusion, anxiety, depression.
-Extrapyramidal changes: tremors, ataxia, dystonia
-Tetany(involuntary contraction of muscles)
-Seizures
-Weakness
Chvostek's sign - ✅✅Facial twitch with tapping ipsilateral facial nerve (hypocalcemia)
Trousseau's sign - ✅✅Carpal spasm on inflation of BP cuff (hypocalcemia)
Hypocalcemia Physical exam findings - ✅✅Proximal Muscle weakness- hyperactive deep tendon
reflexes,
dry skin, brittle hair, brittle nails
, Normal Serum albumin - ✅✅3.5-4.6 g/dl (used to correct calcium)
normal serum magnesium - ✅✅1.5-2.5 mg/dL
In hypocalcemia what will you see in an EKG? - ✅✅-Prolonged QTc interval
Nonspecific T wave changes
Hypocalcemia management in symptomatic acute patients - ✅✅-calcium chloride(IV)
-Calcium gluconate(IV)
-Follow with 1g/hr calcium gluconate over 3 hours(IV)
Hypocalcemia management in asymptomatic chronic patients - ✅✅-Calcium carbonate or other
calcium salt
-Vitamin D or preparations (to help absorb calcium)
Causes of Hypercalcemia - ✅✅-Hyperparathyroidism (most common)
-Malignancy
-Vitamin D excess
-Vitamin A intoxication
-Hyperthyroidism
-Immobilization
-Thiazide diuretic therapy
Hypercalcemia subjective findings: - ✅✅-Neuro: Lethargic, depression, personality changes
-GI: N/V, constipation
-MSK: proximal muscle weakness, bone pain
-Renal: polyuria/nocturia, renal colic (stones)
