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By: Patricia, Rebecca, Chelsea, Denise, Yinet,Keisha, & Sweety

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It is a chemical element with the symbol Ca and atomicnumber 20.

It has atomic mass of 40.078. It is the fifth most abundant element by mass in theearth s crust.

It is a soft gray alkaline earth metal.

It is also the fifth most abundant dissolved ion in seawaterby both molarity and mass. It is the most abundant mineral in the body

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R equired for the formation of bone and teeth

For blood clotting and coagulation

Normal muscle function: such as cardiac contraction andskeletal muscle contraction

Normal heart rhythms

Normal nerve function and transmission of neural impulses.

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Calcium is a positively charged ion or cation. It canbe found in both extracellular fluid andintracellular fluid.

99% of the body s calcium is found in bones andteeth.

1% is found in serum and in soft tissue

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1) The most common or ordered test is a total serumcalcium level.

2) Second measures various forms of calcium inextra cellular fluid.

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The first test is the most common test . Test measures the total amount of serum calcium Normal range is 8.5 to 10.5 mg/dl

Second test measures the various forms of calcium andextracellular fluid .

41 % of extracellular calcium is bound to protein 9% bound to citrate or other organic ions

Approximately is ionized (free calcium) , the only active form of calcium

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Causes:Inadequate dietary intake of calcium or vitamin DR espiratory alkalosis r/t HyperventilationR enal failure and those on Loop DiureticsB urn Patients (calcium can become trapped in burned tissue.)Hypoparathyroidism

HyperphosphatemiaAbuse of Phosphate containing antacids

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Chvostek s sign (twitching of facial nerve inresponse to a tap on the nerve)

Trousseau sign (spasm of forearm on obstructionof its blood supply)

Tetany (worst form of laryngospasm)

Later signs: Arrythmias

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Chvostek s sign Trousseaus sign

R ight arm of patient showing positive Trousseau sign(carpopedal spasm) induced by occluding circulationin the arm with a blood pressure cuff

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Increased intake of calcium rich foods (dairyproducts, carrots, broccoli, green beans andspinach.)Calcium Supplements (1-1.5 hours aftermeals.)Calcium Gluconate IV or Calcium Chloride.Watch closely for cardiac rhythm changes.)

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HyperparathyrodismBone malignanciesFracturesProlonged immobilizationHypophosphatemiaAcidosis

Medications: Antacids w/ Calcium, CalciumPreparations(Oral or IV), Lithium/thiazidediuretics, Vitamin A, Vitamin D

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LethargyWeakness

Personality changesAbdominal painConstipation

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Hydration: IV sodium chlorideLoop diuretics: Furosemide & Ethacrynic Acid

(Increases the calcium excretion)Corticosteroids, biphosphonates, and plicamycinDecrease the calcium intakeHemodialysis or peritoneal dialysis (for life-threatening cases)

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1. If patient is to have a total serum calciumlevel checked, what other chemistry shouldbe considered?

A) CB CB ) CMP

C) B one DensityD) Serum Albumin

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Serum Albumin

B ecause calcium binds to Albumin, so if thethe calcium level is low the Albumin levelwill be low as well

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2.) A 25 year old female underwent a bonedensity exam. The results indicated lowmineral levels and small percentage of boneloss. This is an indication of early signs of .

A) Iron defiency - anemiaB ) HyperkalemiaC) OsteoporosisD) B one cancer

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Osteoporosis

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3 ) A 5 year child old was seen by his pediatrician theDr. prescribed a calcium supplement due to a lowcalcium level. On the patient s follow up visit anew calcium test revealed low levels still. Inaddition to taking a supplement the dr.recommended that Mom do which of thefollowing: (select all that apply)

A) Drink milkB

) Have child play outside in the sunC) Consume more Spinach or KaleD) Double the calcium supplement intake

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4) A patient presents to the E R stuporous and withB radycardia. The pt. suddenly went into cardiacarrest and slipped into a coma. Chemistries wereevaluated and serum calcium level was 11.5 mg/dl.What condition could have contributed to the Pt.slipping into a coma?

A) HypermagnesiaB ) Hyperkalemia

C) HyponatremiaD) Hypercalcemia

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D) Hypercalcemia

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5) Patient has an increased Albumin level and isunable to absorb calcium. What iscontributing to the patients inability toabsorb the calcium?

A) Albumin binds with calcium and so it renders it ineffective.B ) High PTH levelC) Patient is immunocompromisedD) Decreased protein level

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A) Albumin binds with calcium and so it

renders it ineffective.

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CalciumCalcium R obbersR obbersA high protein diet can increase calcium loss.Too much caffeine or too many soft drinks can also inhibit calciumabsorption.Low levels of vitamin D. Vitamin D is needed for calcium to be absorbedin the GI tract.

Fiber interferes with absorption of calcium particularly bean, nut, wheatbran or seed fiberToo much salt. This can cause calcium to be lost through the kidney .

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Calcium R obbers Cont...

Certain medications such as water pills (diuretics), steroids,anti-seizure medications, immunosuppressive medications,non-steroidal anti-inflammatory drugs ( NSAIDs likeibuprofen, naproxen), asthma medication with steroidsOxalic acid in spinach and Swiss chard, rhubarb, almonds

and chocolate combine with calcium to form calciumoxalate, a salt the body can not use.Lifestyle choices such as cigarette use, more than 2 alcoholicdrinks a day.Sedentary lifestyle. The lack of weight bearing exercisesuch as walking, running, weight lifting will decrease bonemass.On the other hand too much calcium block the absorptionof iron and zinc

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http://dietary-suppl ements.info.nih.gov/factsheets/calcium.asp

Lippencott, Williams & Wilkins, Fluids & Electrolytes madeIncredibly Easy. (2005) New York : Wolters Kluwer

Publishinghttp://www.youtube.com/watch?v=8D1L-Id_hYg

B arefoot, R obert R . and Carl J. R eich, MD. (2002) The CalciumFactor: The Scientific Secret of Health and Youth.Wickenburg, PA: Deonna Enterprises Publishing