Ana Dominique G.

Espia BSN III 10

CALCIUM IMBALANCES
HYPOCALCEMIA Hypocalcemia is an electrolyte imbalance and is indicated by a low level of calcium in the blood. The normal adult value for calcium is 4.5 5.5 mEq/L. Calcium is important for healthy bones and teeth, as well as for normal muscle and nerve function. Normal blood calcium levels are maintained through the actions of parathyroid hormone (PTH), your kidneys and intestines. Causes: Vitamin D deficiency Chronic renal failure Magnesium deficiency Alcoholism Biphosphonate therapy - drugs used to treat high blood calcium levels or pills used to treat osteoporosis. Certain types of leukemia or blood disorders A complication of chemotherapy, tumor lysis syndrome, occurs when your body breaks down tumor cells rapidly, after chemotherapy. This may cause hypocalcemia, high blood potassium levels, and other electrolyte abnormalities. This is very serious, and if your blood test results indicate you suffer from it, your doctor or health care provider will need to closely monitor you during this time. Drugs such as diuretics, estrogens replacement therapy, fluorides, glucose, insulin, excessive laxative use, and magnesium may also lead to hypocalcemia. Certain things in your diet, like caffeine, phosphates (found in soda pop), and certain antibiotics may make it difficult for you to absorb calcium. Vitamin D, however, helps you to absorb calcium in your body. Symptoms: The most common sign of hypocalcemia is what is called "neuromuscular irritability." Your nerves and muscles, which are directly related to blood calcium levels, may spasm or twitch. If your blood test results indicate hypocalcemia, you may notice muscle cramps in your legs or your arms. The symptoms of hypocalcemia you experience may relate to how fast or how slowly the fall in blood calcium levels occur. o If you have long-standing low blood calcium levels, you may notice no symptoms of hypocalcemia. o If you have an "acute" or sudden drop in your blood calcium level, you may notice more twitching. You may notice, with mildly lowered blood calcium levels, numbness and tingling of your fingers and toes. You may notice that you are depressed or more irritable if you have mildly low hypocalcemia.

Ana Dominique G. Espia BSN III 10

With severely lowered blood calcium levels, you may become confused or disoriented. Your heart muscle may contract irregularly due to the electrolyte disturbance.

HYPERCALCEMIA Hypercalcemia is an electrolyte imbalance and is indicated by an excess of calcium in the blood. The normal adult value for calcium is 4.5-5.5 mEq/L. There are many reasons for an elevated blood calcium level. Reasons for the hypercalcemia may include: Cancer that started in the bone or cancer that has spread to the bone. Some cancers can cause hypercalcemia themselves, without spread to the bone. Other conditions such as; overactive parathyroid gland or Paget's disease of the bone. Some medications cause hypercalcemia such as: alkaline antacids, diethylstilbesterol (DES), long-term use of diuretics, estrogens and progesterone. What Happens In Hypercalcemia? Cancer cells that spread to the bone can secrete substances that can cause cells found in the bone called osteoclasts to dissolve or "eat away" a portion of the bone. These tumors or lesions weaken the bone and can lead to complications. Some of the complications resulting from this bone break down are bone pain, fractures and less commonly, hypercalcemia. Symptoms: Mild hypercalcemia may not produce any symptoms. However, symptoms of nausea, poor appetite, vomiting and constipation may be present with mild increases in blood calcium levels. Moderate high levels of hypercalcemia may produce fatigue or excessive tiredness. Heart rhythm abnormalities, increased urinary frequency, and kidney stones may also be present. With higher levels of hypercalcemia, patients may experience muscle twitching, anxiety, depression, personality changes and confusion. With very high levels of hypercalcemia excessive sleepiness, coma even death may occur. The severity of symptoms for hypercalcemia depends not only on how high the calcium level is, but also on how fast the rise in serum calcium has occurred. Things You Can Do If Your Blood Test Results Indicate Hypercalcemia: It is important that you stay well hydrated. Drink 2 to 3 quarts of fluid every 24 hours, unless you are instructed otherwise. Take anti-nausea and anti-diarrhea medications as directed also follow dietary recommendations.

Ana Dominique G. Espia BSN III 10

Keep active, weight-bearing activities such as walking are helpful. Being immobile aggravates hypercalcemia.