Which of the following diagnoses is most appropriate for a patient with hypocalcemia?
A. Constipation, bowel
B. High risk for injury: bleeding
C. Airway clearance, ineffective
D. High risk for injury: confusion
Correct Answer: B. High risk for injury: bleeding
A patient with hypocalcemia may bleed, since calcium is required for normal blood clotting. First, calcium may play a role in vascular reactivity. Hypocalcemia could therefore lead to higher BP because of increased arterial vascular tone. A and D are diagnoses appropriate for a patient with hypercalcemia.
Option A: Auscultate bowel sounds. Hypotonicity leads to constipation when the smooth muscle tone is inadequate to produce peristalsis. Maintain bulk in diet. Constipation may be a problem because of decreased GI tone.
Option C: This is not associated with fluctuating calcium levels. Monitor respiratory rate, effort, and rhythm. Place a tracheostomy set at the bedside. Hypocalcemia may result in laryngeal stridor leading to respiratory arrest.
Option D: Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed in hypercalcemia. Lethargy and fatigue can progress to convulsions or coma.
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