decrease renal excretion of the calcium and further elevate serum calcium level

Decrease renal excretion of the calcium and further

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decrease renal excretion of the calcium and further elevate serum calcium level Instructed to avoid dehydration and to seek immediate health care if condition that commonly produce dehydration(vomiting, diarrhea) occur risk of hypercalcemic crisis Mobility Encouraged as much as possible bones that are subjected to normal stress give up less calcium Bed rest increase calcium excretion and the risk for renal calculi Oral phosphates lower the serum calcium level in some patient long term use not recommended because of the risk of ectopic calcium
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400 Test 5 – Chapter 52 (Thyroid and Parathyroid Gland) 10 Diet and medications Avoid a diet with restricted or excess calcium If patient has coexisting peptic ulcers prescribed antacids and protein feedings are necessary Anorexia are common efforts are made to improve the appetite Prune juice, stool softeners, and physical activity along with increased fluid intake help offset constipation Nursing Care Risk for injury Really fragile bones – risk for fractures – handle patients carefully Educate on how to prevent fractures and falls Encourage early ambulation to prevent muscle atrophy and promote excretion of calcium and promote bone health Assess strength prior to getting them up and assist until you know how strong they are Altered Urinary Elimination Can commonly get kidney stones Let them know they need to stay hydrated – encourage lots of fluids Constipation Dehydration can lead to constipation, so increase fluids, encourage activity, high bulk diet Altered nutrition: less than body requirements Avoid foods high in calcium (milk products, green leafy veggies) Issues with appetite, find ways to stimulate appetite Do good oral care Give small frequent meals Teach s/s of hyper and hypocalcemia Complications: Hypercalcemic Crisis Acute hypercalcemic crisis can occur with extreme elevation of serum calcium levels Serum calcium levels greater than 15 mg/dL result in neurologic, cardiovascular, and renal symptoms that can be life threatening Treatments rehydration with large volumes of IV fluids, diuretic agents to promote renal excretion of excess calcium and phosphate therapy to correct hypophosphatemia and decrease serum calcium levels by promoting calcium deposition in bone and reducing the gastrointestinal absorption of calcium Cytotoxic agents(mithramycin), calcitonin, and dialysis may be used in emergency situations to decrease serum calcium level quickly Combination of calcitonin and corticosteroids has been administered in emergencies to reduce the serum calcium level by increasing calcium deposition Other agents may be administered to decrease serum calcium level include biphosphonates etidronate (Didronel) and pamidronate (Aredial) Expert assessment and care are required to minimize complications Nursing alert the patient in acute hypercalcemic crisis requires close monitoring for life threatening complications and prompt
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  • Spring '19
  • Parathyroid gland

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