Treatment measures, Medications, Surgery and Nursing Interventions
By Brandon Arndt
Treatment Measures:
Short-term or initial treatment
  • Slow infusion of calcium chloride, calcium gluconate, or calcium gluceptate
  • Monitor electrolytes
  • ECG monitoring
    • High serum calcium levels can cause serious dysrhythmias
    • Rebreathing into a paper bag to reduce pH in order to increase available calcium in the body
    • PTH replacement may be used only temporarily because of its costs and it is administered parenterally
Long-Term medication treatment
  • Supplemental calcium - orally (at least 1.5 to 3 g/day in divided doses)

  • Supplemental vitamin D - orally (helps promote absorption of calcium)
Preferred preparations include:
  • Dihydrotachysterol (Hytakerol)
  • 1,25-dihydroxycholecalciferol (calcitriol[Rocaltrol])
  • Ergocalciferol (Calciferol)

  • High calcium meal plan
    • Dark green vegetables, tofu, cheese and dairy products

  • Monitor calcium levels 3 to 4 times a year
Nursing Interventions:
  • Promote nutrition and electrolyte balance
  • Encourage progressive activity
  • Promote comfort and safety to prevent falls
  • Teaching to include medications and referral for follow up visits to monitor treatment



References:
Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L., & Camera, I. (2011). Medical surgical nursing: assessment and management of clinical problems (8th ed.). St. Louis, MO: Elsevier Mosby.
Hogan, M. A. (2008). Medical Surgical Nursing: Review and Rationales (2nd ed.) Upper Saddle River, NJ: Pearson Prentice Hall.