Hypocalcaemia

Irrespective of the potential metabolic acidosis, Initial management of both DKA and HHS is focused on rehydration. The aim is to replace fluids in the both the intravascular and extra vascular spaces, while simultaneously diluting glucose levels (and thus lower osmolality) and counter-regulatory hormones (Raghavan, 2014) The Monash Health HHS & DKA

Insufficient calcium supply/intake: Each day, we lose calcium through our skin, sweat, urine and faeces, however, the body cannot produce calcium to replace it. A lack of calcium in bone impedes the process of bone restoration that must occur in order to replace lost bone tissue. A constant supply of calcium is required by the blood, so if calcium levels are insufficient, it will leech from the bones into the blood where it is required.

If someone receives inadequate amounts of calcium, a calcium deficiency might occur. A calcium deficiency, or hypocalcemia, happens when inadequate amounts of

calcium intake in large amounts to be able to reverse this condition. However, as the studies

“Fluid replacement is essential to counteract the dehydration and hyperosmolarity caused by hyperglycemia” (Capriotti & Frizell, 2016). This is why 0.9% NaCl solution at 1 liter/hour for two hours intravenously (IV) was prescribed to be administered to Mr. M. It is an isotonic intravenous solution that has the same tonicity as blood and also called normal saline (Capriotti & Frizell, 2016). According to the Davis’ drugs guide, the normal saline is used for the treatment of metabolic alkalosis. Sodium as a major cation in the extracellular fluid that assists in maintenance of water distribution, fluid and electrolyte balance, acid-base equilibrium, and osmotic pressure. Mr.M is in the state of hyperosmolarity and fluid and electrolyte

Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body's four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck. The parathyroid glands make parathyroid hormone, which helps sustain a suitable balance of calcium in the bloodstream and in tissues that depend on calcium for good functioning. Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an increase of one or more of the parathyroid glands causes overproduction of the hormone, developing in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism. Secondary hyperparathyroidism happens as a result of additional disease that primarily causes low levels of calcium in the body and over time, increased

Active vitamin D, also called calcitriol, is more like a hormone than a vitamin. Vitamin D helps your body absorb and use calcium.

Hyperparathyroidism…is usually discover long before signs or symptoms of this disorder even begin to manifest themselves. When symptoms start to present themselves, they're are mostly resulting because of damage or dysfunction in other parts of the body due to high calcium levels that are circulating in the bloodstream and urine OR it could be because of too little calcium in bones.

Potassium (K+) is a major intracellular cation and is responsible for electrical conduction throughout the body. Additionally, it is necessary for proper heart and muscle function, and digestion. The normal serum potassium range is between 3.5-5.0 mEq/L; hyperkalemia occurs when potassium levels exceed 5.0 mEq/L. Monitoring and treating hyperkalemia is quintessential to primary care as excess potassium can heart blocks and ventricular fibrillation which can result in sudden death (Pannone et al., 2012).

Guidelines from the American journal of medicine will be followed from Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations.

When examining the lab results of the patient listed, it was found that the patient is experiencing hypocalcemia. Hypocalcemia can be described as a low calcium value which has the potential to be an extremely dangerous illness and needs to be treated according to the severity of the value. There is a given range where the calcium level needs to fall, and that is between 8.5 to 10.5 mg/dL (Goltzman, 2014). If the value falls below 8.5 mg/dL than the severity of the deficiency needs to be determined. In the body, calcium is used in many different areas both inside the cell, as well as outside of the cell to perform a range of functions. If the amount of calcium is deficient then those certain functions are going to be altered which can cause many issues in the body (Goltzman, 2014).

Thank you for reading my post and responding. You bring up some good points. I do feel that we would need more information to decide if a potassium sparing diuretic would work for this patient. It would depend on what she is on the diuretic for, if this is the first time that she has been hypokalemic and is the main cause of her hypokalemia because of the diuretic. But if she was switched to a potassium sparing diuretic by the physician then it would be Spironolactone, Triamterene, or Amiloride.

First Maria needs to understand what hyperparathyroidism (HPT) is, mainly Primary Hyperparathyroidism (PHPT). HPT can be asymptomatic, or present with other symptoms such as kidney stones, increase urination, weakness, confusion, depression, bone pains and bone weakness. HPT happens when the parathyroid releases too much of the parathyroid hormone (PTH) into the blood, causing increased PTH levels in the blood. When this happens the blood does not have enough calcium in it, so it goes to the biggest reservoir for calcium- the bones. 99% of calcium is stored in the bones. Increased calcium need in the blood leads to increased bone resorption; this is when the cells in the bone break down the bone tissue to release the needed minerals, results

Nursing care of hyponatremia require understanding of the relationship between sodium and fluid balance and the role of vasopressin, recognition of a patient’s volume status, onset of the of sodium deficit, severity of signs and symptoms, and degree of the sodium deficit. Depending on the severity (acute vs chronic) of the condition and the selected treatments, serum sodium levels should be measured every 1- 2 hours during initial treatment and at least every 4 hours until symptoms resolve. Oral care is important as patients to have a dry mouth due to fluid restrictions. According to hyponatremia treatment guidelines chronic hyponatremia must be corrected to less than 10 to 12 mEq/L over 24 hours and less than 18 mEq/L over 48 hours in order

The main concern with HHNC is the client diuresing . This is a concern because of the loss of fluid, which in early stages results in hyponatremia . Later in the disease process, the patient will display elevated serum sodium levels, due to excessive fluid loss. This is a late sign that will be seen in a comatose patient suffering from HHNC . When a patient is constantly losing fluid , as such the case with HHNC, the patient’s serum level are increasingly elevated due to less fluid in the vascular space. This a main reason for elevate osmolality levels. Therefore , the patient will display signs of hypernatremia . Such signs, would include increased thirst or impaired thirst due to fluid loss and elevated serum sodium levels. Muscle weakness,