Which of the following findings would the nurse expect to assess in hypercalcemia?
A. Prolonged QRS complex
B. Tetany
C. Petechiae
D. Urinary calculi
Correct Answer: D. Urinary calculi
Urinary calculi may occur with hypercalcemia. Symptoms of hypercalcemia are usually seen when serum calcium levels are more than 12 mg/dl. Irrespective of the etiology, the broad signs and symptoms can be summarized as “groans, bones, stones, moans, thrones and psychic overtones”. Tetany and petechiae are signs of hypocalcemia.
Option A: Shortened, not prolonged QRS complex would be seen in hypercalcemia. Severe hypercalcemia inhibits neuromuscular and myocardial depolarization leading to muscle weakness and arrhythmias. Cardiovascular effects include prolonged PR interval, short QT interval, widened QRS complex, and bradycardia.
Option B: Generally induced by a rapid decline in serum ionized calcium. Tetany is usually most dangerous and most commonly seen in the presence of respiratory alkalosis causing hypocalcemia. Hypocalcemia is a common cause of tetany and neuromuscular irritability. An alkaline environment lowers calcium levels and induces tetany, whereas an acidic environment is protective.
Option C: Parathyroid hormone enhances osteoclastic bone resorption and distal tubular reabsorption of calcium. In addition, it mediates the absorption of calcium from the intestine. Vitamin D is known to regulate PTH release, intestinal absorption of calcium, and also medicare’s PTH stimulated bone reabsorption.
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