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What is the normal range for Ca++?
9-11mg/dL
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Ca is obtained how?
ingested foods
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Ca existed in the body in what 2 forms?
bound and ionized (bound or free)
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When Ca is bound it is usually attached to what?
plasma protein
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When measuring Ca lab test measure what type of Ca?
ionized Ca++
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Ca is primary stored where in the body?
Bones
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What 2 major functions does Ca have on bones?
provides strength and density
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What major role does Ca have the muscles?
allows for normal muscle contractions
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What major role does Ca play in nerve impulse?
tramission of nerve impulse
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What major role does Ca play in blood?
intervenes in normal blood clotting
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PTH (releases free ___ from bone storage sites directly into plasma, which is know as __________; Then PTH stimulates _______ ___ activation which increases ________ absorption of dietary Ca, which inhibits _____ excretion of Ca, and stimulates _____ reabsorption of Ca.
- Ca
- resorption
- Vitamin D
- intestinal
- renal
- renal
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PTH is stimulated by what?
low Ca++ serum levels (parathyroid)
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Calcitonin does what to Ca serum levels? and how does it do it?
- decrease Ca serum levels
- by inhibiting bone resorption (movement of Ca out of bones)
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More than 99% of what electrolyte is combine with Ca to be concentrated in the skeletal system?
Phosphorus (p.316)
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A decreased plasma pH (acidosis) decreases Ca binding to what? which leads to what?
- albumin (plasma protein)
- more ionized Ca++ (p.317)
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An increase plasma pH (alkalosis) increases what? and leads to what?
- Ca binding
- decreased ionized Ca++ (p.317)
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Vitamin D is important for absorption of what?
Ca from the GI tract.
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What is the abnormal level for hyperCa?
>11mg/dL
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Breast cancer, lung cancer and multiple myeloma are examples of __________ which can cause HyperCa.
malignancies
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What type of hormonal abnormality can cause hyperCa?
hyperparathyroidism
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What type of overdose can cause HyperCa?
Vitamin D
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Prolonged what can cause HyperCa?
immobilization
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What 4 cardiac clinical manifestations would you see with a person with HyperCa?
- increase HR
- HTH
- bounding pulse
- arrhythmias
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What kind of respiratory movements would you see with a person with HyperCa? and why?
- ineffective
- b/c profound skeletal muscle weekness
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A person with HyperCa would have impaired what?
Give 2 examples:
- LOC
- Disorientation and lethergy
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A pt with HyperCa would have an increase what? which causes what 2 major things?
- urine output
- dehydration and renal calculi
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A pt with HyperCa would have decrease what? which causes what 3 major things?
- GI motility
- hypoactive bowl sounds, abdominal distention, & constipation
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A person with HyperCa has a faster what?
Clotting time
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What kind of diuretics would you us for a pt with HyperCa?
loop diuretics
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What kind of solution would you use to hydrate a person with HyperCa?
NS
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When treating a person with HyperCa the use of Pilcamycin (Mithracin), penicillamine (Cuprimine, Pendramine) are examples of what? and how do they work?
- Ca binders
- Inhibits bone reabsorption
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When treating HyperCa you want to use synthetic what?
Calcitonin and phosphorus
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What is a very effective nursing intervention for a person with HyperCa?
mobilization
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When dealing with hyperCa a good nursing care is monitoring what?
lab studies
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When dealing with hyperCa a good nursing care is assessing for what?
other symptoms
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When dealing with HyperCa a good nursing care is avoiding what kinds of meds?
meds containing Ca and Vitemin D
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When dealing with HyperCa a good nursing care is?
ambulation
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A cause of HypoCa is due to decrease ________ (example) and increase ____ (examples)
- intake (lactose intolerance)
- loss (diarrhea, GI drainage)
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HypoCa is caused by decrease production of wha?
PTH
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Based on the notes list the 5 causes of HypoCa in bullet 3?
Hyperproteinemia, alkalosis, acute pancreatits, Hyperphosphatemia, removal of parathyroid gland.
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_____ failure can cause HypoCa
renal
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Mal-absorptions problems such as _____ ________ can cause HypoCa
crohn's disease
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A person with HypoCa has frequent painful _____ spasms (example) in what 2 areas? and normally at what times?
- muscle
- calfs and foot
- rest or sleep
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For a person with HypoCa you want to ask the about what type of history?
thyroid disease or surgery
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What 2 circulatory manifestations would you notice with a person with HypoCa?
decrease pulse and BP
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What 4 things would you notice in a person with HypoCa?
Clue: ATI cramps
- anxiety
- twitching
- irratibility
- cramps
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A person with HypoCa would have a positive what?
trousseau's and chvostek's signs
(jsut like HypoMg)
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A person with HypoCa would have increase what? give 2 examples?
- GI motility
- hyperactive bowl sounds & diarrhea
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A pt with HypoCa will have pathologic _______ and brittle ____.
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When dealing with HypoCa you want to treat what?
the causes
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When dealing with HypoCa you want to give oral or IV what?
Ca supplements
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When treating HypoCa why is it so important to treat the pts pain and anxiety?
to prevent hyperventilation-induced respiratory alkalosis
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