8/6/2019 1 Calcium Done
1/29
1
By: Patricia, Rebecca, Chelsea, Denise, Yinet,Keisha, & Sweety
8/6/2019 1 Calcium Done
2/29
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
8/6/2019 1 Calcium Done
3/29
8/6/2019 1 Calcium Done
4/29
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.
8/6/2019 1 Calcium Done
5/29
8/6/2019 1 Calcium Done
6/29
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
8/6/2019 1 Calcium Done
7/29
1) The most common or ordered test is a total serumcalcium level.
2) Second measures various forms of calcium inextra cellular fluid.
8/6/2019 1 Calcium Done
8/29
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
8/6/2019 1 Calcium Done
9/29
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
8/6/2019 1 Calcium Done
10/29
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
8/6/2019 1 Calcium Done
11/29
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
8/6/2019 1 Calcium Done
12/29
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.)
8/6/2019 1 Calcium Done
13/29
8/6/2019 1 Calcium Done
14/29
HyperparathyrodismBone malignanciesFracturesProlonged immobilizationHypophosphatemiaAcidosis
Medications: Antacids w/ Calcium, CalciumPreparations(Oral or IV), Lithium/thiazidediuretics, Vitamin A, Vitamin D
8/6/2019 1 Calcium Done
15/29
LethargyWeakness
Personality changesAbdominal painConstipation
8/6/2019 1 Calcium Done
16/29
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)
8/6/2019 1 Calcium Done
17/29
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
8/6/2019 1 Calcium Done
18/29
Serum Albumin
B ecause calcium binds to Albumin, so if thethe calcium level is low the Albumin levelwill be low as well
8/6/2019 1 Calcium Done
19/29
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
8/6/2019 1 Calcium Done
20/29
Osteoporosis
8/6/2019 1 Calcium Done
21/29
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
8/6/2019 1 Calcium Done
22/29
8/6/2019 1 Calcium Done
23/29
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
8/6/2019 1 Calcium Done
24/29
D) Hypercalcemia
8/6/2019 1 Calcium Done
25/29
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
8/6/2019 1 Calcium Done
26/29
A) Albumin binds with calcium and so it
renders it ineffective.
8/6/2019 1 Calcium Done
27/29
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 .
8/6/2019 1 Calcium Done
28/29
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
28
8/6/2019 1 Calcium Done
29/29
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