· Normal range 8.5 to 10.5 mg/dL
· 99% body’s calcium is combined with phosphorus and concentrated in skeletal system.
· Parathyroid hormone, calcitonin, Vitamin D controls calcium balance.
· Calcium levels are often reciprocal with phosphorus levels.
Serum Ca2+ < 8.5 mg/dL
· Chronic renal failure
· Vitamin D deficiency
· Magnesium deficiency
· Loop diuretics
· Easy fatigability
· Depression, anxiety, confusion Numbness and tingling of limbs, toes
· Hyperreflexia, muscle cramps
· Chvostek sign
· Trousseau’s sign
· Prolonged bleeding time
· Cardiac insufficiency, hypotension, dysrhythmias and prolonged QT interval
Chvostek’s sign is described as the twitching of facial muscles in response to tapping over the area of the facial nerve.
Trousseau’s sign is carpopedal spasm that results from ischemia, such as that induced by pressure applied to the upper arm from an inflated sphygmomanometer cuff
· If Asymptomatic – Oral replacement
· If Symptomatic or Severe- 10% Calcium GIuconate IV, 10-30 ml, or 10% Calcium Chloride IV, 10 ml