-predominantly neuromuscular and cardiovascular
-neuromuscular: paresthesia of toes, fingers, face, twitching, cramps, or tremors, laryngospasm, bronchospasm, increase in nerve excitability- Classic sign: tetany evidenced by Trousseau's and Chvostek's sign
-Neuro:anxiety, confusion, irritability which can progress to seizures
-fractures, hyperactive DTR, hypotension,diminished responsed to digitoxin, dopamine, norepinephrine, decreased CO, subsequent arrythmias, prolonged ST segment and QT intervals.
-If your pt is recovering from parathyroid or thyroid surgery, keep calcium gluconate on hand for a sudden drop in calcium levels
-monitor VS, assess rate, dept, rhythm of respiration, watch for stridor, dyspnea, and crowing
-keep trachyotomy tray and handheld resuscitation bag at bedside in case laryngospasm occurs
-place your pt on cardiac monitor
check for Chvestek's and Trousseau's signs
-insert and maintain a patent IV line
-Give calcium supplements as ordered 1-2 hours after meals. If GI upset occurs, supplement with milk
monitor lab tests: calcium, albumin, magnesium, and phosphorus. Check ionized calcium levels after every 4 units of blood transfused
-encourage older pts to take calcium supplements and exercise.
-reorient a confused pt, provide a calm, quiet environment
-Most affect the heart, skeletal muscle, and nervous system
-include confusion, lethargy, depression, altered mental status, muscle weakness, hyporeflexia, characteriostic ECG changes, hypertension, bone pain, abdominal pain and constipation, N/V, anorexia, polyuria, and extreme thirst, pathologic fractures, bone pain