Page 249 - Saunders Comprehensive Review For NCLEX-RN

status
4. Increased water loss: Increased rate of metabolism,
fever, hyperventilation, infection, excessive
diaphoresis, watery diarrhea, diabetes insipidus

C. Assessment (see Table 8-4)

D. Interventions
1. If the cause is fluid loss, prepare to administer IV
infusions.

2. If the cause is inadequate renal excretion of

sodium, prepare to administer diuretics that promote
sodium loss.
3. Restrict sodium and fluid intake as prescribed.
IX. Hypocalcemia

The normal calcium level is 9 to 10.5 mg/dL (2.25 to 2.75 mmol/L)

A. Description: Hypocalcemia is a serum calcium level lower than
9.0 mg/dL (2.25 mmol/L).

B. Causes

1. Inhibition of calcium absorption from the
gastrointestinal tract
a. Inadequate oral intake of calcium
b. Lactose intolerance
c. Malabsorption syndromes such as celiac
sprue or Crohn’s disease
d. Inadequate intake of vitamin D
e. End-stage kidney disease
2. Increased calcium excretion
a. Kidney disease, polyuric phase
b. Diarrhea
c. Steatorrhea
d. Wound drainage, especially
gastrointestinal
3. Conditions that decrease the ionized fraction of
calcium
a. Hyperproteinemia
b. Alkalosis
c. Medications such as calcium chelators
or binders
d. Acute pancreatitis
e. Hyperphosphatemia
f. Immobility
g. Removal or destruction of the

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