Electrolyte Imbalance NURS 624 Questions with Answers
(100% Correct Answers)
Normal Calcium range Serum vs Ionized —Answer: Serum 8.6-10.2 mg/dl
Ionized 4.6-5.3 mg/dl
Causes of hypocalcemia include: —Answer: -Hypoparathyroidism (usually from surgery)
-Hypomagnesemia
-Pancreatitis (acute)
-Vitamin D Deficiency
-Chronic ETOH
-Acute Tumor Lysis Syndrome
-Rhabdomyolysis
-Massive blood Transfusion
-Medications (phenytoin, cisplatin, or estrogen)
Subjective findings of Hypocalcemia: —Answer: -Mental changes: Confusion, anxiety,
depression.
-Extrapyramidal changes: tremors, ataxia, dystonia
-Tetany(involuntary contraction of muscles)
-Seizures
-Weakness
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,Chvostek's sign —Answer: Facial twitch with tapping ipsilateral facial nerve (hypocalcemia)
Trousseau's sign —Answer: Carpal spasm on inflation of BP cuff (hypocalcemia)
Hypocalcemia Physical exam findings —Answer: Proximal Muscle weakness- hyperactive
deep tendon reflexes,
dry skin, brittle hair, brittle nails
Normal Serum albumin —Answer: 3.5-4.6 g/dl (used to correct calcium)
normal serum magnesium —Answer: 1.5-2.5 mg/dL
In hypocalcemia what will you see in an EKG? —Answer: -Prolonged QTc interval
Nonspecific T wave changes
Hypocalcemia management in symptomatic acute patients —Answer: -calcium chloride(IV)
-Calcium gluconate(IV)
-Follow with 1g/hr calcium gluconate over 3 hours(IV)
Hypocalcemia management in asymptomatic chronic patients —Answer: -Calcium carbonate
or other calcium salt
-Vitamin D or preparations (to help absorb calcium)
Causes of Hypercalcemia —Answer: -Hyperparathyroidism (most common)
-Malignancy
-Vitamin D excess
-Vitamin A intoxication
-Hyperthyroidism
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, -Immobilization
-Thiazide diuretic therapy
Hypercalcemia subjective findings: —Answer: -Neuro: Lethargic, depression, personality
changes
-GI: N/V, constipation
-MSK: proximal muscle weakness, bone pain
-Renal: polyuria/nocturia, renal colic (stones)
Hypercalcemia Physical findings —Answer: -Absent deep tendon reflexes
-Hypertension (chronic hypercalcemia)
-Hypotension (sever cases with volume depletion)
Hypercalcemia: Labs/Diagnostics —Answer: PTH level
Thyroid panel
Vitamin D levels
Bone density test
PHRP level
EKG (Short QTc)
what is calcitonin —Answer: a hormone your thyroid makes and releases to help regulate
calcium levels in your blood by decreasing them
Hypercalcemia Management Severe —Answer: -IV 0.9% saline
-Calcitonin
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(100% Correct Answers)
Normal Calcium range Serum vs Ionized —Answer: Serum 8.6-10.2 mg/dl
Ionized 4.6-5.3 mg/dl
Causes of hypocalcemia include: —Answer: -Hypoparathyroidism (usually from surgery)
-Hypomagnesemia
-Pancreatitis (acute)
-Vitamin D Deficiency
-Chronic ETOH
-Acute Tumor Lysis Syndrome
-Rhabdomyolysis
-Massive blood Transfusion
-Medications (phenytoin, cisplatin, or estrogen)
Subjective findings of Hypocalcemia: —Answer: -Mental changes: Confusion, anxiety,
depression.
-Extrapyramidal changes: tremors, ataxia, dystonia
-Tetany(involuntary contraction of muscles)
-Seizures
-Weakness
© 2025 All rights reserved
,Chvostek's sign —Answer: Facial twitch with tapping ipsilateral facial nerve (hypocalcemia)
Trousseau's sign —Answer: Carpal spasm on inflation of BP cuff (hypocalcemia)
Hypocalcemia Physical exam findings —Answer: Proximal Muscle weakness- hyperactive
deep tendon reflexes,
dry skin, brittle hair, brittle nails
Normal Serum albumin —Answer: 3.5-4.6 g/dl (used to correct calcium)
normal serum magnesium —Answer: 1.5-2.5 mg/dL
In hypocalcemia what will you see in an EKG? —Answer: -Prolonged QTc interval
Nonspecific T wave changes
Hypocalcemia management in symptomatic acute patients —Answer: -calcium chloride(IV)
-Calcium gluconate(IV)
-Follow with 1g/hr calcium gluconate over 3 hours(IV)
Hypocalcemia management in asymptomatic chronic patients —Answer: -Calcium carbonate
or other calcium salt
-Vitamin D or preparations (to help absorb calcium)
Causes of Hypercalcemia —Answer: -Hyperparathyroidism (most common)
-Malignancy
-Vitamin D excess
-Vitamin A intoxication
-Hyperthyroidism
© 2025 All rights reserved
, -Immobilization
-Thiazide diuretic therapy
Hypercalcemia subjective findings: —Answer: -Neuro: Lethargic, depression, personality
changes
-GI: N/V, constipation
-MSK: proximal muscle weakness, bone pain
-Renal: polyuria/nocturia, renal colic (stones)
Hypercalcemia Physical findings —Answer: -Absent deep tendon reflexes
-Hypertension (chronic hypercalcemia)
-Hypotension (sever cases with volume depletion)
Hypercalcemia: Labs/Diagnostics —Answer: PTH level
Thyroid panel
Vitamin D levels
Bone density test
PHRP level
EKG (Short QTc)
what is calcitonin —Answer: a hormone your thyroid makes and releases to help regulate
calcium levels in your blood by decreasing them
Hypercalcemia Management Severe —Answer: -IV 0.9% saline
-Calcitonin
© 2025 All rights reserved
