Materiały źródłowe

• #1 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Hypercalcemia is a total serum calcium concentration 10.4 mg/dL ( 2.60 mmol/L) or ionized serum calcium 5.2 mg/dL ( 1.30 mmol/L). […] Treatment to increase calcium excretion and reduce bone resorption of calcium involves saline, sodium diuresis, and medications such as those used for treatment of seizure disorders. […] Diagnosis is by measuring serum ionized calcium and parathyroid hormone concentrations. […] The treatment used depends on both the degree and the cause of hypercalcemia. Volume repletion with saline is an essential element of care. […] In mild hypercalcemia (serum calcium 11.5 mg/dL [ 2.9 mmol/L]), in which symptoms are mild or absent, treatment is deferred pending definitive diagnosis. […] When symptoms are significant, treatment aimed at lowering serum calcium is necessary. Oral phosphate can be used.

• #2 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/766373-overview

  Hypercalcemia can result when too much calcium enters the extracellular fluid or when there is insufficient calcium excretion from the kidneys. Approximately 90% of cases of hypercalcemia are caused by hyperparathyroidism or malignancy. […] Treatment of hypercalcemia includes the following: Volume repletion with isotonic sodium chloride solution, Loop diuretics, Bisphosphonates, Denosumab, Peritoneal dialysis or hemodialysis, Surgical correction of hyperparathyroidism. […] Mild cases of hypercalcemia can be asymptomatic and are more often diagnosed incidentally from routine blood tests. Because calcium metabolism normally is tightly controlled by the body, even mild persistent elevations above normal signal disease and should be investigated.

• #3 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia, which is an excessive level of calcium in the blood, can occur in patients with hyperparathyroidism, hyperthyroidism, renal disease, or as a side effect of certain medications. This can lead to an electrolyte imbalance as high levels of calcium can disrupt the balance of other electrolytes in the body, such as potassium and magnesium. The resulting electrolyte imbalances can cause symptoms ranging from mild to severe and can potentially be life-threatening if left untreated. […] Nursing care plans and nursing diagnosis play a critical role in managing these conditions. Nurses are responsible for assessing patients, identifying symptoms, and developing a care plan that is tailored to the patients specific needs. In this article, we will explore the nursing care plans and nursing diagnosis for hypercalcemia and hypocalcemia.

• #4 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/766373-overview

  Hypercalcemia can result when too much calcium enters the extracellular fluid or when there is insufficient calcium excretion from the kidneys. Approximately 90% of cases of hypercalcemia are caused by hyperparathyroidism or malignancy. […] Treatment of hypercalcemia includes the following: Volume repletion with isotonic sodium chloride solution, Loop diuretics, Bisphosphonates, Denosumab, Peritoneal dialysis or hemodialysis, Surgical correction of hyperparathyroidism. […] Mild cases of hypercalcemia can be asymptomatic and are more often diagnosed incidentally from routine blood tests. Because calcium metabolism normally is tightly controlled by the body, even mild persistent elevations above normal signal disease and should be investigated.

• #5 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia, which is an excessive level of calcium in the blood, can occur in patients with hyperparathyroidism, hyperthyroidism, renal disease, or as a side effect of certain medications. This can lead to an electrolyte imbalance as high levels of calcium can disrupt the balance of other electrolytes in the body, such as potassium and magnesium. The resulting electrolyte imbalances can cause symptoms ranging from mild to severe and can potentially be life-threatening if left untreated. […] Nursing care plans and nursing diagnosis play a critical role in managing these conditions. Nurses are responsible for assessing patients, identifying symptoms, and developing a care plan that is tailored to the patients specific needs. In this article, we will explore the nursing care plans and nursing diagnosis for hypercalcemia and hypocalcemia.

• #6 Resistant Hypercalcemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131067

  Hypercalcemia can be grouped based on serum calcium levels as follows: […] Resistant hypercalcemia can be defined as persistently elevated calcium levels despite multiple therapy modalities or if re-administration is required within two weeks of initial therapy. […] Antiresorptive agents have proven to be effective in the management of resistant hypercalcemia. […] However, despite preliminary treatment, denosumab has been proven to be an excellent choice of therapy in resistant hypercalcemia cases. […] The importance of the interprofessional approach cannot be under-emphasized. Early identification of symptomatic hypercalcemia by the emergency medicine physician is essential to initiate immediate hydration. […] The nephrology and hemodialysis team played a vital role in resistant hypercalcemia, requiring hemodialysis to normalize calcium levels.

• #7 Resistant Hypercalcemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131067

  Hypercalcemia can be grouped based on serum calcium levels as follows: […] Resistant hypercalcemia can be defined as persistently elevated calcium levels despite multiple therapy modalities or if re-administration is required within two weeks of initial therapy. […] Antiresorptive agents have proven to be effective in the management of resistant hypercalcemia. […] However, despite preliminary treatment, denosumab has been proven to be an excellent choice of therapy in resistant hypercalcemia cases. […] The importance of the interprofessional approach cannot be under-emphasized. Early identification of symptomatic hypercalcemia by the emergency medicine physician is essential to initiate immediate hydration. […] The nephrology and hemodialysis team played a vital role in resistant hypercalcemia, requiring hemodialysis to normalize calcium levels.

• #8 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Hypercalcemia can cause few or no symptoms. So, you might not know you have it until routine blood tests show a high level of calcium. […] If you have hypercalcemia, your healthcare professional looks for its cause. You might need imaging tests of your bones or lungs. This helps find out if the cause is a disease such as cancer or sarcoidosis. […] If your hypercalcemia is mild, you might not need treatment right away. You and your healthcare professional may wait to see if symptoms start or become worse. Your bones and kidneys might be checked over time to be sure they stay healthy. […] For hypercalcemia that is more serious, your healthcare professional might recommend medicines or treatment of the underlying disease. Sometimes, treatment includes surgery. […] For some people, medicines such as these may be recommended: Calcitonin (Miacalcin). This hormone from salmon controls calcium levels in the blood. Mild upset stomach can be a side effect.

• #9 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/766373-overview

  Hypercalcemia can result when too much calcium enters the extracellular fluid or when there is insufficient calcium excretion from the kidneys. Approximately 90% of cases of hypercalcemia are caused by hyperparathyroidism or malignancy. […] Treatment of hypercalcemia includes the following: Volume repletion with isotonic sodium chloride solution, Loop diuretics, Bisphosphonates, Denosumab, Peritoneal dialysis or hemodialysis, Surgical correction of hyperparathyroidism. […] Mild cases of hypercalcemia can be asymptomatic and are more often diagnosed incidentally from routine blood tests. Because calcium metabolism normally is tightly controlled by the body, even mild persistent elevations above normal signal disease and should be investigated.

• #10 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  Identify signs and symptoms of hypercalcemia. […] Determine appropriate treatment options for hypercalcemia. […] Hypercalcemia is often an incidental finding detected on labwork completed for other reasons. […] When calcium levels rise above 12 mg/dL, patients typically present with clinical signs and symptoms, including polyuria, polydipsia, constipation, weakness, neuropsychiatric effects, nausea, vomiting, fatigue, anorexia, and confusion. […] Patients with hypercalcemia can become volume-depleted and require intravenous (IV) hydration. […] The goals of treating hypercalcemia include increased elimination from the extracellular fluid, reduced gastrointestinal absorption, and decreased bone resorption. […] Treatment options differ based on the etiology and severity of hypercalcemia.

• #11 Hypercalcemia – Electrolyte Imbalances – Fundamentals of Nursing – Picmonic for Nursing RN

  https://www.picmonic.com/pathways/nursing/courses/standard/fundamentals-of-nursing-273/electrolyte-imbalances-1365/hypercalcemia_7855

  Hypercalcemia is defined as a serum calcium level higher than 10.5 mg/dL. Because the normal range is narrow, even slight increases can have severe effects. […] Hypercalcemia decreases neuromuscular excitability, with the most common symptom presenting as lethargy. Fatigue, confusion, and a decreased level of consciousness may be observed with severe cases leading to coma. […] Interventions for hypercalcemia aim to reduce serum calcium levels thus, no calcium intake should be permitted. This includes stopping IV solutions containing calcium such as Ringers lactate and oral drugs containing calcium. […] Calcitonin is a drug used to inhibit calcium resorption from bone and thereby helps to prevent hypercalcemia. It is often administered intravenously in cases of severe hypercalcemia (hypercalcemic crisis, serum calcium greater than 14 mg/dL) since it is relatively fast-acting.

• #12 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  In severe cases, dialysis may be needed to remove excess calcium from the blood, ESPECIALLY IF THEY ALSO HAVE HEART FAILURE OR SEVERE RENAL FAILURE. […] Hypercalcemia can cause a variety of ECG changes, including: […] ARRHYTHMIAS ARE LESS COMMON with hypercalcemia than with other electrolyte abnormalities but still can cause them including:

• #13 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #14 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Hypercalcemia is a total serum calcium concentration 10.4 mg/dL ( 2.60 mmol/L) or ionized serum calcium 5.2 mg/dL ( 1.30 mmol/L). […] Treatment to increase calcium excretion and reduce bone resorption of calcium involves saline, sodium diuresis, and medications such as those used for treatment of seizure disorders. […] Diagnosis is by measuring serum ionized calcium and parathyroid hormone concentrations. […] The treatment used depends on both the degree and the cause of hypercalcemia. Volume repletion with saline is an essential element of care. […] In mild hypercalcemia (serum calcium 11.5 mg/dL [ 2.9 mmol/L]), in which symptoms are mild or absent, treatment is deferred pending definitive diagnosis. […] When symptoms are significant, treatment aimed at lowering serum calcium is necessary. Oral phosphate can be used.

• #15 A Practical Approach to Hypercalcemia | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0501/p1959.html

  Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients. Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. […] An initial diagnostic work-up should include measurement of intact parathyroid hormone, and any medications that are likely to be causative should be discontinued. […] It is essential to exclude other causes before considering parathyroid surgery, and patients should be referred for parathyroidectomy only if they meet certain criteria. […] Hypercalcemic crisis is a life-threatening emergency. Aggressive intravenous rehydration is the mainstay of management in severe hypercalcemia, and antiresorptive agents, such as calcitonin and bisphosphonates, frequently can alleviate the clinical manifestations of hypercalcemic disorders.

• #16 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  Hypercalcemia is when the blood has HIGH CALCIUM LEVELS, which can lead to deadly hypercalcemia complications. These complications can be severe and potentially LIFE-THREATENING if not identified and managed promptly. […] As healthcare professionals who may have to care for patients with hypercalcemia, nurses need to be aware of the potential complications associated with this condition. […] In this article, we will discuss levels of hypercalcemia, causes, treatment, complications, and monitoring parameters that nurses need to know about. […] Hypercalcemia can cause a wide range of symptoms, most NON-SPECIFIC. The severity and type of symptoms depend on the calcium level in the blood, the underlying cause of hypercalcemia, and how quickly the levels change. […] When performing a physical exam for a patient suspected of having hypercalcemia, the nurse should assess for the following:

• #17 A Practical Approach to Hypercalcemia | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0501/p1959.html

  Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients. Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. […] An initial diagnostic work-up should include measurement of intact parathyroid hormone, and any medications that are likely to be causative should be discontinued. […] It is essential to exclude other causes before considering parathyroid surgery, and patients should be referred for parathyroidectomy only if they meet certain criteria. […] Hypercalcemic crisis is a life-threatening emergency. Aggressive intravenous rehydration is the mainstay of management in severe hypercalcemia, and antiresorptive agents, such as calcitonin and bisphosphonates, frequently can alleviate the clinical manifestations of hypercalcemic disorders.

• #18 Treatment of hypercalcemia – UpToDate

  https://www.uptodate.com/contents/treatment-of-hypercalcemia

  Treatment for hypercalcemia should be aimed both at lowering the serum calcium concentration and, if possible, treating the underlying disease. Effective treatments reduce serum calcium by inhibiting bone resorption, increasing urinary calcium excretion, or decreasing intestinal calcium absorption. The optimal choice varies with the cause and severity of hypercalcemia. […] The treatment of hypercalcemia will be reviewed here, with emphasis on the management of hypercalcemia in patients with malignant disease. The modalities described below apply in varying degrees to patients with other causes of hypercalcemia.

• #19 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Hypercalcemia is a total serum calcium concentration 10.4 mg/dL ( 2.60 mmol/L) or ionized serum calcium 5.2 mg/dL ( 1.30 mmol/L). […] Treatment to increase calcium excretion and reduce bone resorption of calcium involves saline, sodium diuresis, and medications such as those used for treatment of seizure disorders. […] Diagnosis is by measuring serum ionized calcium and parathyroid hormone concentrations. […] The treatment used depends on both the degree and the cause of hypercalcemia. Volume repletion with saline is an essential element of care. […] In mild hypercalcemia (serum calcium 11.5 mg/dL [ 2.9 mmol/L]), in which symptoms are mild or absent, treatment is deferred pending definitive diagnosis. […] When symptoms are significant, treatment aimed at lowering serum calcium is necessary. Oral phosphate can be used.

• #20 Hypercalcemia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia

  Hypercalcemia happens when you have higher-than-normal levels of calcium in your blood. It’s usually caused by primary hyperparathyroidism or certain cancers and is treatable with surgery and/or medication. […] Hypercalcemia can affect anyone at any age, but its most common in females over age 50 (after menopause). In most cases, this is due to an overactive parathyroid gland. […] Treatment of hypercalcemia depends on what’s causing it and how severe it is. In mild cases of hypercalcemia, your healthcare provider may tell you to: Drink more water. Switch to a non-thiazide diuretic or blood pressure medication. Stop taking or lower your dose of calcium-rich antacid tablets. Stop taking or lower your dose of calcium supplements and calcium-containing supplements, such as multivitamins. […] If the hypercalcemia is due to an overactive parathyroid gland, your provider will most likely recommend surgery to have the overactive parathyroid gland(s) removed.

• #21 A Practical Approach to Hypercalcemia | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0501/p1959.html

  The principal challenges in the management of hypercalcemia are distinguishing primary hyperparathyroidism from conditions that will not respond to parathyroidectomy and knowing when it is appropriate to refer the patient for surgery. […] It is essential that physicians know how to evaluate and optimally manage patients with hypercalcemia, because treatment and prognosis vary according to the underlying disorder. […] In patients with mild hypercalcemia, adequate hydration should be encouraged and immobilization discouraged. In symptomatic patients, a loop diuretic (e.g., furosemide) can be prescribed. […] In patients with severe hypercalcemia, the mainstay of management is aggressive intravenous rehydration. Normal saline should be used to achieve a urine output of 200 mL per hour. […] In cases of hypercalcemic crisis resulting from primary hyperparathyroidism, urgent parathyroidectomy is potentially curative.

• #22 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Another treatment is increasing urinary calcium excretion by giving isotonic saline plus a loop diuretic. […] Moderate hypercalcemia (serum calcium 11.5 mg/dL [ 2.88 mmol/L] and 18 mg/dL [ 4.51 mmol/L]) can be treated with isotonic saline and a loop diuretic as is done for mild hypercalcemia or, depending on its cause, with medications that decrease bone resorption (usually bisphosphonates, calcitonin, or infrequently plicamycin or gallium nitrate), corticosteroids, or chloroquine. […] In severe hypercalcemia (serum calcium 18 mg/dL [ 4.5 mmol/L] or with severe symptoms), hemodialysis with low-calcium dialysate may be needed in addition to other treatments. […] Hypercalcemia of malignancy demands aggressive treatment due to its progressive nature and mortality risk. […] Treatment for hyperparathyroidism depends on severity.

• #23 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Another treatment is increasing urinary calcium excretion by giving isotonic saline plus a loop diuretic. […] Moderate hypercalcemia (serum calcium 11.5 mg/dL [ 2.88 mmol/L] and 18 mg/dL [ 4.51 mmol/L]) can be treated with isotonic saline and a loop diuretic as is done for mild hypercalcemia or, depending on its cause, with medications that decrease bone resorption (usually bisphosphonates, calcitonin, or infrequently plicamycin or gallium nitrate), corticosteroids, or chloroquine. […] In severe hypercalcemia (serum calcium 18 mg/dL [ 4.5 mmol/L] or with severe symptoms), hemodialysis with low-calcium dialysate may be needed in addition to other treatments. […] Hypercalcemia of malignancy demands aggressive treatment due to its progressive nature and mortality risk. […] Treatment for hyperparathyroidism depends on severity.

• #24 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  As a nurse, it is essential to monitor patients with hypercalcemia closely to identify and manage any potential complications. The following parameters should be observed: […] The treatment of hypercalcemia depends on the severity of the condition and the underlying cause. […] Patients who have moderate to severe hypercalcemia often are volume depleted. This helps to correct the hypovolemia and increase calcium excretion in the urine. […] Calcitonin is a hormone that can lower calcium levels in the blood by decreasing bone resorption. This is usually RESERVED FOR SEVERE HYPERCALCEMIA with neurologic symptoms like decreased mental status. […] These medications can reduce bone resorption and lower calcium levels in the blood. Bisphosphonates are used for LONGER-TERM CONTROL OF HYPERCALCEMIA, especially when related to MALIGNANCY.

• #25 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Administer isotonic saline and sodium sulfate PO or IV. Emergency measures in severe hypercalcemia are used to dilute extracellular calcium concentration and inhibit tubular reabsorption of calcium, thereby increasing urinary excretion. […] Prepare for and assist with hemodialysis. Rapid reduction of serum calcium may be necessary to correct the life-threatening situation.

• #26 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #27 Hypercalcemia – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/hypercalcemia/

  Hypercalcemia treatment should be started in patients who present with hypercalcemia symptoms or have a serum calcium level of more than 14 mg/dl. Hypercalcemia treatment goals include eliminating excess calcium from the extracellular fluid, decreasing absorption of calcium in the digestive tract, and decreasing resorption of calcium in the bones. […] An infusion of 0.9% saline should be started at twice the maintenance rate. This is continued until urine output is greater than or equal to 200 mL/h to 300 mL/h. Patients with heart failure or insufficient renal function should receive hemodialysis to quickly lower the serum calcium level. […] Furosemide may be given to increase excretion of calcium. […] Patients with high parathyroid hormone levels should be evaluated for possible surgery to remove the source of increased parathyroid hormone secretion.

• #28 High calcium levels (hypercalcemia) | Canadian Cancer Society

  https://cancer.ca/en/treatments/side-effects/high-calcium-levels

  Hypercalcemia means there is too much calcium in the blood. It is the most common life-threatening complication of cancer in adults. Hypercalcemia develops in 10% to 20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM). […] Report symptoms to your healthcare team as soon as possible. […] Once the cause of hypercalcemia is known, your healthcare team can treat it. This includes treating the underlying cancer to lower calcium levels in the blood. You may also need other treatments for hypercalcemia, including the following: […] Replacing fluids is the first and most important step in treating hypercalcemia. Extra fluids treat dehydration and improve kidney function. When the kidneys work better, they can remove more calcium from the blood.

• #29 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Calcimimetics. This type of medicine can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to manage hypercalcemia. […] Bisphosphonates. These osteoporosis medicines can quickly lower calcium levels when given through a vein (IV). Often, they’re used to treat hypercalcemia due to cancer. Risks linked with this treatment include thigh fractures as well as breakdown of the jaw, called osteonecrosis. […] Denosumab (Prolia, Xgeva). This medicine often is used to treat people with hypercalcemia caused by cancer who don’t respond well to bisphosphonates. […] Prednisone. Short-term use of steroid pills such as prednisone can help against hypercalcemia caused by high vitamin D levels. […] IV fluids and loop diuretics. Very high calcium levels can be a medical emergency. You might need treatment with IV fluids in the hospital to quickly lower your calcium level. This helps prevent heart rhythm problems or damage to the nervous system. You also might need medicines called loop diuretics if your calcium level stays high. Or you might need them if too much fluid builds up in your body.

• #30 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Hypercalcemia can cause few or no symptoms. So, you might not know you have it until routine blood tests show a high level of calcium. […] If you have hypercalcemia, your healthcare professional looks for its cause. You might need imaging tests of your bones or lungs. This helps find out if the cause is a disease such as cancer or sarcoidosis. […] If your hypercalcemia is mild, you might not need treatment right away. You and your healthcare professional may wait to see if symptoms start or become worse. Your bones and kidneys might be checked over time to be sure they stay healthy. […] For hypercalcemia that is more serious, your healthcare professional might recommend medicines or treatment of the underlying disease. Sometimes, treatment includes surgery. […] For some people, medicines such as these may be recommended: Calcitonin (Miacalcin). This hormone from salmon controls calcium levels in the blood. Mild upset stomach can be a side effect.

• #31 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  As a nurse, it is essential to monitor patients with hypercalcemia closely to identify and manage any potential complications. The following parameters should be observed: […] The treatment of hypercalcemia depends on the severity of the condition and the underlying cause. […] Patients who have moderate to severe hypercalcemia often are volume depleted. This helps to correct the hypovolemia and increase calcium excretion in the urine. […] Calcitonin is a hormone that can lower calcium levels in the blood by decreasing bone resorption. This is usually RESERVED FOR SEVERE HYPERCALCEMIA with neurologic symptoms like decreased mental status. […] These medications can reduce bone resorption and lower calcium levels in the blood. Bisphosphonates are used for LONGER-TERM CONTROL OF HYPERCALCEMIA, especially when related to MALIGNANCY.

• #32 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Calcimimetics. This type of medicine can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to manage hypercalcemia. […] Bisphosphonates. These osteoporosis medicines can quickly lower calcium levels when given through a vein (IV). Often, they’re used to treat hypercalcemia due to cancer. Risks linked with this treatment include thigh fractures as well as breakdown of the jaw, called osteonecrosis. […] Denosumab (Prolia, Xgeva). This medicine often is used to treat people with hypercalcemia caused by cancer who don’t respond well to bisphosphonates. […] Prednisone. Short-term use of steroid pills such as prednisone can help against hypercalcemia caused by high vitamin D levels. […] IV fluids and loop diuretics. Very high calcium levels can be a medical emergency. You might need treatment with IV fluids in the hospital to quickly lower your calcium level. This helps prevent heart rhythm problems or damage to the nervous system. You also might need medicines called loop diuretics if your calcium level stays high. Or you might need them if too much fluid builds up in your body.

• #33 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Calcimimetics. This type of medicine can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to manage hypercalcemia. […] Bisphosphonates. These osteoporosis medicines can quickly lower calcium levels when given through a vein (IV). Often, they’re used to treat hypercalcemia due to cancer. Risks linked with this treatment include thigh fractures as well as breakdown of the jaw, called osteonecrosis. […] Denosumab (Prolia, Xgeva). This medicine often is used to treat people with hypercalcemia caused by cancer who don’t respond well to bisphosphonates. […] Prednisone. Short-term use of steroid pills such as prednisone can help against hypercalcemia caused by high vitamin D levels. […] IV fluids and loop diuretics. Very high calcium levels can be a medical emergency. You might need treatment with IV fluids in the hospital to quickly lower your calcium level. This helps prevent heart rhythm problems or damage to the nervous system. You also might need medicines called loop diuretics if your calcium level stays high. Or you might need them if too much fluid builds up in your body.

• #34 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Calcimimetics. This type of medicine can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to manage hypercalcemia. […] Bisphosphonates. These osteoporosis medicines can quickly lower calcium levels when given through a vein (IV). Often, they’re used to treat hypercalcemia due to cancer. Risks linked with this treatment include thigh fractures as well as breakdown of the jaw, called osteonecrosis. […] Denosumab (Prolia, Xgeva). This medicine often is used to treat people with hypercalcemia caused by cancer who don’t respond well to bisphosphonates. […] Prednisone. Short-term use of steroid pills such as prednisone can help against hypercalcemia caused by high vitamin D levels. […] IV fluids and loop diuretics. Very high calcium levels can be a medical emergency. You might need treatment with IV fluids in the hospital to quickly lower your calcium level. This helps prevent heart rhythm problems or damage to the nervous system. You also might need medicines called loop diuretics if your calcium level stays high. Or you might need them if too much fluid builds up in your body.

• #35 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Calcimimetics. This type of medicine can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to manage hypercalcemia. […] Bisphosphonates. These osteoporosis medicines can quickly lower calcium levels when given through a vein (IV). Often, they’re used to treat hypercalcemia due to cancer. Risks linked with this treatment include thigh fractures as well as breakdown of the jaw, called osteonecrosis. […] Denosumab (Prolia, Xgeva). This medicine often is used to treat people with hypercalcemia caused by cancer who don’t respond well to bisphosphonates. […] Prednisone. Short-term use of steroid pills such as prednisone can help against hypercalcemia caused by high vitamin D levels. […] IV fluids and loop diuretics. Very high calcium levels can be a medical emergency. You might need treatment with IV fluids in the hospital to quickly lower your calcium level. This helps prevent heart rhythm problems or damage to the nervous system. You also might need medicines called loop diuretics if your calcium level stays high. Or you might need them if too much fluid builds up in your body.

• #36 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Conditions linked with overactive parathyroid glands often can be cured by surgery to remove the tissue that’s causing the problem. In many people, only one of the four parathyroid glands is affected. […] Patients can come into the office feeling a variety of symptoms that are generally nonspecific but rather debilitating for them. In many of these cases, we’re able to treat hyperparathyroidism and watch these symptoms literally go away. […] What we strive for is really to have a very efficient and effective itinerary for our patients and know they’re going to be operated on by very high-volume, experienced parathyroid surgeons. They feel confident that they’re going to come here and get the care they need and deserve.

• #37 Hypercalcemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528

  Conditions linked with overactive parathyroid glands often can be cured by surgery to remove the tissue that’s causing the problem. In many people, only one of the four parathyroid glands is affected. […] Patients can come into the office feeling a variety of symptoms that are generally nonspecific but rather debilitating for them. In many of these cases, we’re able to treat hyperparathyroidism and watch these symptoms literally go away. […] What we strive for is really to have a very efficient and effective itinerary for our patients and know they’re going to be operated on by very high-volume, experienced parathyroid surgeons. They feel confident that they’re going to come here and get the care they need and deserve.

• #38 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  If all other strategies fail, hemodialysis is used to treat hypercalcemia. […] Malignancy-associated hypercalcemia is best managed by an interprofessional healthcare team, including an oncologist, internist, endocrinologist, and surgeon, who guides treatment. […] Nursing staff have a key role in case management by assisting with patient assessment, providing counseling, and serving as a liaison between the different specialties.

• #39 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  In severe cases, dialysis may be needed to remove excess calcium from the blood, ESPECIALLY IF THEY ALSO HAVE HEART FAILURE OR SEVERE RENAL FAILURE. […] Hypercalcemia can cause a variety of ECG changes, including: […] ARRHYTHMIAS ARE LESS COMMON with hypercalcemia than with other electrolyte abnormalities but still can cause them including:

• #40 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia, which is an excessive level of calcium in the blood, can occur in patients with hyperparathyroidism, hyperthyroidism, renal disease, or as a side effect of certain medications. This can lead to an electrolyte imbalance as high levels of calcium can disrupt the balance of other electrolytes in the body, such as potassium and magnesium. The resulting electrolyte imbalances can cause symptoms ranging from mild to severe and can potentially be life-threatening if left untreated. […] Nursing care plans and nursing diagnosis play a critical role in managing these conditions. Nurses are responsible for assessing patients, identifying symptoms, and developing a care plan that is tailored to the patients specific needs. In this article, we will explore the nursing care plans and nursing diagnosis for hypercalcemia and hypocalcemia.

• #41 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  As a nurse, it is essential to monitor patients with hypercalcemia closely to identify and manage any potential complications. The following parameters should be observed: […] The treatment of hypercalcemia depends on the severity of the condition and the underlying cause. […] Patients who have moderate to severe hypercalcemia often are volume depleted. This helps to correct the hypovolemia and increase calcium excretion in the urine. […] Calcitonin is a hormone that can lower calcium levels in the blood by decreasing bone resorption. This is usually RESERVED FOR SEVERE HYPERCALCEMIA with neurologic symptoms like decreased mental status. […] These medications can reduce bone resorption and lower calcium levels in the blood. Bisphosphonates are used for LONGER-TERM CONTROL OF HYPERCALCEMIA, especially when related to MALIGNANCY.

• #42 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #43 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #44 Hypocalcemia & Hypercalcemia: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypocalcemia-hypercalcemia-nursing-diagnosis-care-plan/

  Possible causes of hypercalcemia include the following: […] Nursing Process: The body must maintain calcium homeostasis to ensure appropriate functional processes, especially of the muscles and bones. […] Nurses must regularly check patients calcium blood levels and manage their imbalances to avoid complications. […] Once the nurse identifies nursing diagnoses for hypocalcemia or hypercalcemia, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Nursing Diagnosis: Electrolyte Imbalance […] Expected outcomes: Patient will demonstrate serum calcium levels within normal limits. […] Patient will manifest an absence of muscle symptoms (such as muscle twitching, cramps, or paresthesias). […] Patient will display no ECG irregularities.

• #45 Hypercalcemia NCLEX Review Notes with Mnemonics & Quiz

  https://www.registerednursern.com/hypercalcemia-nclex-review-notes-with-mnemonics-quiz-fluid-electrolytes-for-nursing-students/

  Normal calcium levels in the blood: 8.6 to 10.0 mg/dL (10.0 is hypercalcemia) […] Nursing Interventions for Hypercalcemia […] Mild cases of Hypercalcemia: Keep patient hydrated (decrease chance of renal stone formation) […] Moderate cases of Hypercalcemia: Administer calcium reabsorption inhibitors: Calcitonin, Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS) […] Severe cases of Hypercalcemia: Prepare patient for dialysis.

• #46 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #47 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Hypercalcemia: Risk for Electrolyte Imbalance […] The client will display heart rhythm, muscle strength, cognitive status, and laboratory results within the normal limit for the client. […] Assess the level of consciousness and neuromuscular status, including muscle tone, strength, and movement. Nerve and muscle activity is depressed. Lethargy and fatigue can progress to convulsions or coma. […] Monitor cardiac rate and rhythm. Be aware that cardiac arrest can occur in a hypercalcemic crisis. Overstimulation of cardiac muscle occurs with resultant dysrhythmias and ineffective cardiac contraction. Sinus bradycardia, sinus dysrhythmias, wandering pacemaker, and atrioventricular (AV) block may be noted. Hypercalcemia creates a predisposition to cardiac arrest. […] Encourage fluid intake of 3 to 4 liters per day, including sodium-containing fluids (within cardiac tolerance), and use of acid-ash juices such as cranberry and prune, if kidney stones are present or suspected. Reduces dehydration, encourages urinary flow and clearance of calcium, and reduces the risk of stone formation.

• #48 Hypercalcemia NCLEX Review Notes with Mnemonics & Quiz

  https://www.registerednursern.com/hypercalcemia-nclex-review-notes-with-mnemonics-quiz-fluid-electrolytes-for-nursing-students/

  Normal calcium levels in the blood: 8.6 to 10.0 mg/dL (10.0 is hypercalcemia) […] Nursing Interventions for Hypercalcemia […] Mild cases of Hypercalcemia: Keep patient hydrated (decrease chance of renal stone formation) […] Moderate cases of Hypercalcemia: Administer calcium reabsorption inhibitors: Calcitonin, Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS) […] Severe cases of Hypercalcemia: Prepare patient for dialysis.

• #49 Hypocalcemia & Hypercalcemia: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypocalcemia-hypercalcemia-nursing-diagnosis-care-plan/

  Interventions: Administer medications as prescribed. Calcium from the digestive system can be absorbed more easily with vitamin D. Give calcium supplements with vitamin D for hypocalcemia. […] Treat underlying conditions. Malignancy, hypoparathyroidism, renal, and skeletal diseases can all contribute to calcium imbalances. […] Risk for Injury: Risk for injury associated with calcium imbalance is caused by alterations in muscle contraction, resulting in muscle weakness and CNS changes for hypercalcemia or tetany and seizure for hypocalcemia. […] Expected outcomes: Patient will not have any incidence of injury. […] Patient will demonstrate good muscle tone. […] Patient will be able to verbalize an understanding of how hypo/hypercalcemia can lead to injuries. […] Administer medications as ordered. Consuming sufficient amounts of calcium and vitamin D can preserve bone strength and lower the risk of injury. […] Implement seizure precautions. Seizure precautions are intended to protect the patient from injury. […] Prepare the patient for possible dialysis. If treatment for severe hypercalcemia fails to lower serum calcium levels, prepare the patient for dialysis to remove the excess calcium.

• #50 Hypercalcemia NCLEX Review Notes with Mnemonics & Quiz

  https://www.registerednursern.com/hypercalcemia-nclex-review-notes-with-mnemonics-quiz-fluid-electrolytes-for-nursing-students/

  Normal calcium levels in the blood: 8.6 to 10.0 mg/dL (10.0 is hypercalcemia) […] Nursing Interventions for Hypercalcemia […] Mild cases of Hypercalcemia: Keep patient hydrated (decrease chance of renal stone formation) […] Moderate cases of Hypercalcemia: Administer calcium reabsorption inhibitors: Calcitonin, Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS) […] Severe cases of Hypercalcemia: Prepare patient for dialysis.

• #51 Hypocalcemia & Hypercalcemia: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypocalcemia-hypercalcemia-nursing-diagnosis-care-plan/

  Interventions: Administer medications as prescribed. Calcium from the digestive system can be absorbed more easily with vitamin D. Give calcium supplements with vitamin D for hypocalcemia. […] Treat underlying conditions. Malignancy, hypoparathyroidism, renal, and skeletal diseases can all contribute to calcium imbalances. […] Risk for Injury: Risk for injury associated with calcium imbalance is caused by alterations in muscle contraction, resulting in muscle weakness and CNS changes for hypercalcemia or tetany and seizure for hypocalcemia. […] Expected outcomes: Patient will not have any incidence of injury. […] Patient will demonstrate good muscle tone. […] Patient will be able to verbalize an understanding of how hypo/hypercalcemia can lead to injuries. […] Administer medications as ordered. Consuming sufficient amounts of calcium and vitamin D can preserve bone strength and lower the risk of injury. […] Implement seizure precautions. Seizure precautions are intended to protect the patient from injury. […] Prepare the patient for possible dialysis. If treatment for severe hypercalcemia fails to lower serum calcium levels, prepare the patient for dialysis to remove the excess calcium.

• #52 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Administer isotonic saline and sodium sulfate PO or IV. Emergency measures in severe hypercalcemia are used to dilute extracellular calcium concentration and inhibit tubular reabsorption of calcium, thereby increasing urinary excretion. […] Prepare for and assist with hemodialysis. Rapid reduction of serum calcium may be necessary to correct the life-threatening situation.

• #53 Hypercalcemia and Hypocalcemia (Calcium Imbalances) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/hypercalcemia-and-hypocalcemia-calcium-imbalances-nursing-care-plans/

  Administer isotonic saline and sodium sulfate PO or IV. Emergency measures in severe hypercalcemia are used to dilute extracellular calcium concentration and inhibit tubular reabsorption of calcium, thereby increasing urinary excretion. […] Prepare for and assist with hemodialysis. Rapid reduction of serum calcium may be necessary to correct the life-threatening situation.

• #54 Discharge Instructions for Hypercalcemia | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hypercalcemia

  You have been diagnosed with hypercalcemia. That means you have too much calcium in your blood. Hypercalcemia is often the result of other problems. These include overactive glands, unhealthy bones, long-term bed rest, and some kinds of tumors or cancers. […] Ask your healthcare provider how much fluid you should drink. You may need to drink 3 quarts up to 1 gallon (3 to 4 liters) of fluid every day. Drink as much as directed by your healthcare provider. Keep track of how much fluid you drink. […] You will need to cut back on foods that are high in calcium. […] Don’t take antacid medicines if they list calcium as an ingredient. […] Don’t take vitamin D supplements (more than 800 international units/day) or multivitamin/mineral supplements that also contain calcium unless prescribed by your healthcare provider.

• #55

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8677

  Hypercalcemia is too much calcium in the blood. Several problems can cause too much calcium in the blood. Your doctor will treat you based on how serious the problem is and what is causing it. Since too much calcium can be dangerous, it is important to treat it. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. Drink plenty of fluids. Get at least 2 hours of moderate to vigorous exercise a week. Exercise helps the calcium go back into your bones. Let your doctor know if you take vitamins or other natural health products that have calcium or vitamin D. Call your doctor or nurse advice line now or seek immediate medical care if you are confused or have trouble thinking clearly. Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you are feeling so tired or weak that you cannot do your usual activities. […] You do not get better as expected.

• #56

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8677

  Hypercalcemia is too much calcium in the blood. Several problems can cause too much calcium in the blood. Your doctor will treat you based on how serious the problem is and what is causing it. Since too much calcium can be dangerous, it is important to treat it. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. Drink plenty of fluids. Get at least 2 hours of moderate to vigorous exercise a week. Exercise helps the calcium go back into your bones. Let your doctor know if you take vitamins or other natural health products that have calcium or vitamin D. Call your doctor or nurse advice line now or seek immediate medical care if you are confused or have trouble thinking clearly. Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you are feeling so tired or weak that you cannot do your usual activities. […] You do not get better as expected.

• #57

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8677

  Hypercalcemia is too much calcium in the blood. Several problems can cause too much calcium in the blood. Your doctor will treat you based on how serious the problem is and what is causing it. Since too much calcium can be dangerous, it is important to treat it. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. Drink plenty of fluids. Get at least 2 hours of moderate to vigorous exercise a week. Exercise helps the calcium go back into your bones. Let your doctor know if you take vitamins or other natural health products that have calcium or vitamin D. Call your doctor or nurse advice line now or seek immediate medical care if you are confused or have trouble thinking clearly. Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you are feeling so tired or weak that you cannot do your usual activities. […] You do not get better as expected.

• #58 Discharge Instructions for Hypercalcemia | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hypercalcemia

  Get exercise. If your hypercalcemia was caused by long-term bed rest, try to increase your activity if possible. […] Resume your normal activities as directed by your healthcare provider. […] Keep all appointments for blood tests and follow-up care. Your healthcare provider needs to watch your condition closely. […] Call your healthcare provider right away if you have any of these: Extreme fatigue, Loss of appetite, Trouble urinating or pain when urinating, Blood in your urine, Vomiting or diarrhea, Increased thirst, Irregular heartbeat, Dizziness or lightheadedness, Depression, Confusion.

• #59 Hypercalcemia Complications: what nurses need to know | Health And Willness

  https://healthandwillness.org/hypercalcemia-complications/

  Hypercalcemia is when the blood has HIGH CALCIUM LEVELS, which can lead to deadly hypercalcemia complications. These complications can be severe and potentially LIFE-THREATENING if not identified and managed promptly. […] As healthcare professionals who may have to care for patients with hypercalcemia, nurses need to be aware of the potential complications associated with this condition. […] In this article, we will discuss levels of hypercalcemia, causes, treatment, complications, and monitoring parameters that nurses need to know about. […] Hypercalcemia can cause a wide range of symptoms, most NON-SPECIFIC. The severity and type of symptoms depend on the calcium level in the blood, the underlying cause of hypercalcemia, and how quickly the levels change. […] When performing a physical exam for a patient suspected of having hypercalcemia, the nurse should assess for the following:

• #60 Hypercalcemia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/hypercalcemia

  Depending on your age, kidney function, and bone effects, you might need surgery to remove the abnormal parathyroid glands. This procedure cures most cases of hypercalcemia caused by hyperparathyroidism. […] If you have cancer, your doctor will discuss treatment options with you to help you determine the best ways to treat hypercalcemia. […] Hypercalcemia can cause kidney problems, such as kidney stones and kidney failure. Other complications include irregular heartbeats and osteoporosis. […] Your long-term outlook will depend on the cause and how severe your condition is. Your doctor can determine the best treatment for you. […] You can do your part to help protect your kidneys and bones from damage due to hypercalcemia by making healthy lifestyle choices. Make sure you drink plenty of water. This will keep you hydrated, keep blood levels of calcium down, and decrease your risk of developing kidney stones. […] Make sure to follow guidelines for the doses of over-the-counter supplements and medications to decrease the risk of excessive vitamin D and calcium intake.

• #61 Hypercalcemia – Electrolyte Imbalances – Fundamentals of Nursing – Picmonic for Nursing RN

  https://www.picmonic.com/pathways/nursing/courses/standard/fundamentals-of-nursing-273/electrolyte-imbalances-1365/hypercalcemia_7855

  As the calcium builds up in the body, crystals can form in the kidneys. Over time, the crystals may combine to form renal calculi or kidney stones. […] In most patients, fluid resuscitation with intravenous normal saline can aid in restoring normal serum calcium levels. Exercise caution in patients who are already fluid overloaded e.g. renal or heart failure.

• #62 Hypercalcemia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/hypercalcemia

  Depending on your age, kidney function, and bone effects, you might need surgery to remove the abnormal parathyroid glands. This procedure cures most cases of hypercalcemia caused by hyperparathyroidism. […] If you have cancer, your doctor will discuss treatment options with you to help you determine the best ways to treat hypercalcemia. […] Hypercalcemia can cause kidney problems, such as kidney stones and kidney failure. Other complications include irregular heartbeats and osteoporosis. […] Your long-term outlook will depend on the cause and how severe your condition is. Your doctor can determine the best treatment for you. […] You can do your part to help protect your kidneys and bones from damage due to hypercalcemia by making healthy lifestyle choices. Make sure you drink plenty of water. This will keep you hydrated, keep blood levels of calcium down, and decrease your risk of developing kidney stones. […] Make sure to follow guidelines for the doses of over-the-counter supplements and medications to decrease the risk of excessive vitamin D and calcium intake.

• #63 Hypercalcemia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/hypercalcemia

  Depending on your age, kidney function, and bone effects, you might need surgery to remove the abnormal parathyroid glands. This procedure cures most cases of hypercalcemia caused by hyperparathyroidism. […] If you have cancer, your doctor will discuss treatment options with you to help you determine the best ways to treat hypercalcemia. […] Hypercalcemia can cause kidney problems, such as kidney stones and kidney failure. Other complications include irregular heartbeats and osteoporosis. […] Your long-term outlook will depend on the cause and how severe your condition is. Your doctor can determine the best treatment for you. […] You can do your part to help protect your kidneys and bones from damage due to hypercalcemia by making healthy lifestyle choices. Make sure you drink plenty of water. This will keep you hydrated, keep blood levels of calcium down, and decrease your risk of developing kidney stones. […] Make sure to follow guidelines for the doses of over-the-counter supplements and medications to decrease the risk of excessive vitamin D and calcium intake.

• #64 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Hypercalcemia.aspx

  If a person has kidney failure caused by hypercalcemia, a dialysis machine can be used to clean the blood and reduce the amount of calcium in it. […] Medical advice should be sought before taking any supplements or medication for hypercalcemia, as some may make hypercalcemia worse. […] To help keep hypercalcemia from becoming worse, a person can drink fluids regularly, seek treatment to control nausea and vomiting or to manage an underlying illness causing hypercalcemia, and do appropriate exercise to help reduce bone loss. […] The prognosis for hypercalcemia caused by cancer is often worse than hypercalcemia caused by benign disorders. […] Severe hypercalcemia will present serious symptoms such as seizures and coma and should be treated as a medical emergency.

• #65 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  If these criteria are met, the patients should pursue a parathyroidectomy to reduce calcium levels for a more long-term approach. […] The management of hypercalcemia involves both evidence-based medical interventions and a focused diagnostic approach to ensure cost-effective, patient-centered care. […] In addition to treatment, follow-up becomes equally important and care must be coordinated to ensure effective long-term management of the patient’s condition. […] Early identification and subsequent management can result in decreased morbidity and mortality associated with hypercalcemia. […] The prognosis of hypercalcemia is largely dependent on its etiology. […] The complications of hypercalcemia include the following: Depression, Kidney stones, Bone pain, Constipation, Pancreatitis, Renal failure, Gastric ulcers, Paresthesias, Syncope and arrhythmias, Altered mental status.

• #66 A review of cancer-related hypercalcemia: Pathophysiology, current treatments, and future directions

  https://jmpcr.samipubco.com/article_190729.html

  Cancer-related hypercalcemia is a common metabolic complication seen in patients with advanced malignancies, affecting 10-30% of all cancer patients. […] The timely recognition and management of hypercalcemia are crucial to prevent complications and improve patient outcomes. Therefore, it is essential to explore potential treatment options that target both the underlying causes of hypercalcemia and the associated symptoms. […] The management of cancer-related hypercalcemia involves addressing both the underlying cause and the associated symptoms. […] Initial treatment strategies often involve rehydration with intravenous fluids to enhance renal calcium excretion and promote diuresis. […] Bisphosphonates, such as zoledronic acid and pamidronate, are commonly used in the management of cancer-related hypercalcemia.

• #67 Diagnose and Treat Hypercalcemia of Malignancy | Oncology Nursing Society

  https://www.ons.org/publications-research/voice/news-views/07-2021/diagnose-and-treat-hypercalcemia-malignancy

  Hypercalcemia of malignancy (HCM) is a common paraneoplastic syndrome associated with poor prognosis that affects approximately 20%30% of patients with cancer. […] Elevated calcium levels can result in life-threatening outcomes, but HCM is typically manageable with early diagnosis. Regularly monitoring calcium levels is critical, but practitioners must recognize that it may fluctuate with albumin levels because 40%45% of serum calcium is bound to albumin, so measure serum albumin or ionized calcium levels as well. […] Oncology nurses and advanced practice RNs (ARPNs) alike should be familiar with the four most common etiologies that lead to HCM: humoral, osteolytic, vitamin Dsecreting lymphomas, and ectopic parathyroidism. […] HCM can affect multiple organ systems through several clinical manifestations. Kidney involvement can lead to nephrolithiasis and chronic renal insufficiency.

• #68 Hypercalcemia of Malignancy | SpringerLink

  https://link.springer.com/10.1007/978-3-319-31738-0_70-2

  This chapter discusses hypercalcemia of malignancy, which is the most common biochemical complication of cancer and is recognized as a medical emergency. Hypercalcemia presents with a wide range of clinical symptoms, which in some cases can be severe and life-threatening. […] Where active treatment is appropriate, initial management should consist of rehydration as hypercalcemia results in hypovolemia. Following this, specific calcium-lowering treatment should be considered. Following rehydration, intravenous bisphosphonates have been the treatment of choice for the last 20 years and are effective in the initial treatment for most cases. However, denosumab has become one of the preferred treatments. Guidance to manage recurrent and refractory hypercalcemia is also discussed in this chapter.

• #69 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Another treatment is increasing urinary calcium excretion by giving isotonic saline plus a loop diuretic. […] Moderate hypercalcemia (serum calcium 11.5 mg/dL [ 2.88 mmol/L] and 18 mg/dL [ 4.51 mmol/L]) can be treated with isotonic saline and a loop diuretic as is done for mild hypercalcemia or, depending on its cause, with medications that decrease bone resorption (usually bisphosphonates, calcitonin, or infrequently plicamycin or gallium nitrate), corticosteroids, or chloroquine. […] In severe hypercalcemia (serum calcium 18 mg/dL [ 4.5 mmol/L] or with severe symptoms), hemodialysis with low-calcium dialysate may be needed in addition to other treatments. […] Hypercalcemia of malignancy demands aggressive treatment due to its progressive nature and mortality risk. […] Treatment for hyperparathyroidism depends on severity.

• #70 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  IV hydration with normal saline at a rate of 200 to 300 mL/h is administered to maintain an adequate urine output of more than 100 mL/h, helping restore intravascular volume and increase urinary calcium excretion. […] Calcitonin should be administered at a dose of 4 IU/kg alongside normal saline infusion to help prevent bone resorption and increase urinary calcium excretion. […] Bisphosphonates, such as zoledronic acid (4 mg IV over 15-30 minutes) or pamidronate (60-90 mg IV over 2 hours), are recommended for patients without kidney dysfunction. […] Denosumab works by inhibiting RANKL and was previously considered only for patients who did not respond to zoledronic acid or those with kidney impairment, as it is not cleared by the kidneys. […] Glucocorticoid therapy should be considered for patients with increased 1,25-dihydroxy vitamin D production, such as those with lymphoma or granulomatous diseases, as it reduces vitamin D production and decreases calcium absorption from the intestines.

• #71 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  IV hydration with normal saline at a rate of 200 to 300 mL/h is administered to maintain an adequate urine output of more than 100 mL/h, helping restore intravascular volume and increase urinary calcium excretion. […] Calcitonin should be administered at a dose of 4 IU/kg alongside normal saline infusion to help prevent bone resorption and increase urinary calcium excretion. […] Bisphosphonates, such as zoledronic acid (4 mg IV over 15-30 minutes) or pamidronate (60-90 mg IV over 2 hours), are recommended for patients without kidney dysfunction. […] Denosumab works by inhibiting RANKL and was previously considered only for patients who did not respond to zoledronic acid or those with kidney impairment, as it is not cleared by the kidneys. […] Glucocorticoid therapy should be considered for patients with increased 1,25-dihydroxy vitamin D production, such as those with lymphoma or granulomatous diseases, as it reduces vitamin D production and decreases calcium absorption from the intestines.

• #72 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  IV hydration with normal saline at a rate of 200 to 300 mL/h is administered to maintain an adequate urine output of more than 100 mL/h, helping restore intravascular volume and increase urinary calcium excretion. […] Calcitonin should be administered at a dose of 4 IU/kg alongside normal saline infusion to help prevent bone resorption and increase urinary calcium excretion. […] Bisphosphonates, such as zoledronic acid (4 mg IV over 15-30 minutes) or pamidronate (60-90 mg IV over 2 hours), are recommended for patients without kidney dysfunction. […] Denosumab works by inhibiting RANKL and was previously considered only for patients who did not respond to zoledronic acid or those with kidney impairment, as it is not cleared by the kidneys. […] Glucocorticoid therapy should be considered for patients with increased 1,25-dihydroxy vitamin D production, such as those with lymphoma or granulomatous diseases, as it reduces vitamin D production and decreases calcium absorption from the intestines.

• #73 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  IV hydration with normal saline at a rate of 200 to 300 mL/h is administered to maintain an adequate urine output of more than 100 mL/h, helping restore intravascular volume and increase urinary calcium excretion. […] Calcitonin should be administered at a dose of 4 IU/kg alongside normal saline infusion to help prevent bone resorption and increase urinary calcium excretion. […] Bisphosphonates, such as zoledronic acid (4 mg IV over 15-30 minutes) or pamidronate (60-90 mg IV over 2 hours), are recommended for patients without kidney dysfunction. […] Denosumab works by inhibiting RANKL and was previously considered only for patients who did not respond to zoledronic acid or those with kidney impairment, as it is not cleared by the kidneys. […] Glucocorticoid therapy should be considered for patients with increased 1,25-dihydroxy vitamin D production, such as those with lymphoma or granulomatous diseases, as it reduces vitamin D production and decreases calcium absorption from the intestines.

• #74 FF #151 Hypercalcemia of Malignancy | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/hypercalcemia-of-malignancy/

  Background Up to 30 percent of patients with cancer develop hypercalcemia. Approximately 50% of these patients will die within 30 days of a hypercalcemia diagnosis, even if the hypercalcemia is corrected, which suggests that hypercalcemia is a sign of a hormonally advanced cancer. It is most associated with squamous cell cancers of lung, head and neck, and esophagus, breast cancer, renal cell carcinoma, lymphomas and multiple myeloma. […] Anti-tumor therapy Treatment of the underlying malignancy with systemic therapy (e.g., chemotherapy) is the most definitive way to control hypercalcemia of malignancy long-term. In cases where further anti-neoplastic therapy is not feasible, the decision to treat or not treat hypercalcemia should be made by careful exploration of the patient’s goals of care. In advanced untreatable cancer, the decision to not treat hypercalcemia may be very appropriate.

• #75 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  If all other strategies fail, hemodialysis is used to treat hypercalcemia. […] Malignancy-associated hypercalcemia is best managed by an interprofessional healthcare team, including an oncologist, internist, endocrinologist, and surgeon, who guides treatment. […] Nursing staff have a key role in case management by assisting with patient assessment, providing counseling, and serving as a liaison between the different specialties.

• #76 Malignancy-Related Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482423/

  If all other strategies fail, hemodialysis is used to treat hypercalcemia. […] Malignancy-associated hypercalcemia is best managed by an interprofessional healthcare team, including an oncologist, internist, endocrinologist, and surgeon, who guides treatment. […] Nursing staff have a key role in case management by assisting with patient assessment, providing counseling, and serving as a liaison between the different specialties.

• #77 Hypocalcemia & Hypercalcemia: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hypocalcemia-hypercalcemia-nursing-diagnosis-care-plan/

  Possible causes of hypercalcemia include the following: […] Nursing Process: The body must maintain calcium homeostasis to ensure appropriate functional processes, especially of the muscles and bones. […] Nurses must regularly check patients calcium blood levels and manage their imbalances to avoid complications. […] Once the nurse identifies nursing diagnoses for hypocalcemia or hypercalcemia, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Nursing Diagnosis: Electrolyte Imbalance […] Expected outcomes: Patient will demonstrate serum calcium levels within normal limits. […] Patient will manifest an absence of muscle symptoms (such as muscle twitching, cramps, or paresthesias). […] Patient will display no ECG irregularities.

• #78 Resistant Hypercalcemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131067

  The endocrinologists will primarily coordinate the patient’s care and determine treatment strategies. […] Nurses play significant roles in critical care and closely monitoring patient vitals and hemodynamics. […] These examples of interprofessional interplay show how this approach will drive better patient results in hypercalcemia cases.

• #79 Resistant Hypercalcemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131067

  The endocrinologists will primarily coordinate the patient’s care and determine treatment strategies. […] Nurses play significant roles in critical care and closely monitoring patient vitals and hemodynamics. […] These examples of interprofessional interplay show how this approach will drive better patient results in hypercalcemia cases.

• #80 Resistant Hypercalcemia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131067

  Hypercalcemia can be grouped based on serum calcium levels as follows: […] Resistant hypercalcemia can be defined as persistently elevated calcium levels despite multiple therapy modalities or if re-administration is required within two weeks of initial therapy. […] Antiresorptive agents have proven to be effective in the management of resistant hypercalcemia. […] However, despite preliminary treatment, denosumab has been proven to be an excellent choice of therapy in resistant hypercalcemia cases. […] The importance of the interprofessional approach cannot be under-emphasized. Early identification of symptomatic hypercalcemia by the emergency medicine physician is essential to initiate immediate hydration. […] The nephrology and hemodialysis team played a vital role in resistant hypercalcemia, requiring hemodialysis to normalize calcium levels.

• #81 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  If these criteria are met, the patients should pursue a parathyroidectomy to reduce calcium levels for a more long-term approach. […] The management of hypercalcemia involves both evidence-based medical interventions and a focused diagnostic approach to ensure cost-effective, patient-centered care. […] In addition to treatment, follow-up becomes equally important and care must be coordinated to ensure effective long-term management of the patient’s condition. […] Early identification and subsequent management can result in decreased morbidity and mortality associated with hypercalcemia. […] The prognosis of hypercalcemia is largely dependent on its etiology. […] The complications of hypercalcemia include the following: Depression, Kidney stones, Bone pain, Constipation, Pancreatitis, Renal failure, Gastric ulcers, Paresthesias, Syncope and arrhythmias, Altered mental status.

• #82 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  If these criteria are met, the patients should pursue a parathyroidectomy to reduce calcium levels for a more long-term approach. […] The management of hypercalcemia involves both evidence-based medical interventions and a focused diagnostic approach to ensure cost-effective, patient-centered care. […] In addition to treatment, follow-up becomes equally important and care must be coordinated to ensure effective long-term management of the patient’s condition. […] Early identification and subsequent management can result in decreased morbidity and mortality associated with hypercalcemia. […] The prognosis of hypercalcemia is largely dependent on its etiology. […] The complications of hypercalcemia include the following: Depression, Kidney stones, Bone pain, Constipation, Pancreatitis, Renal failure, Gastric ulcers, Paresthesias, Syncope and arrhythmias, Altered mental status.

• #83 Hypercalcemia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia

  If the hypercalcemia is severe, and/or causing significant symptoms, your provider may recommend immediate hospitalization for IV fluids and other treatments. […] Not all cases of hypercalcemia can be prevented, but avoiding excess intake of calcium pills and calcium-based antacid tablets can help. […] Prognosis, like treatment, depends on the cause and severity of hypercalcemia. When hypercalcemia happens due to a benign condition or temporary situation, it generally has a good prognosis.

• #84 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Hypercalcemia.aspx

  If a person has kidney failure caused by hypercalcemia, a dialysis machine can be used to clean the blood and reduce the amount of calcium in it. […] Medical advice should be sought before taking any supplements or medication for hypercalcemia, as some may make hypercalcemia worse. […] To help keep hypercalcemia from becoming worse, a person can drink fluids regularly, seek treatment to control nausea and vomiting or to manage an underlying illness causing hypercalcemia, and do appropriate exercise to help reduce bone loss. […] The prognosis for hypercalcemia caused by cancer is often worse than hypercalcemia caused by benign disorders. […] Severe hypercalcemia will present serious symptoms such as seizures and coma and should be treated as a medical emergency.

• #85 Epidemiology, clinical features, and management of severe hypercalcemia in critically ill patients | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-019-0606-8

  HCM is associated with high mortality rates, mainly due to underlying malignancies. […] An early aggressive therapy of HCM may prevent these complications, mainly AKI. […] A special attention should be paid to patients with onco-hematological malignancies to detect neurological complications associated with HCM.

• #86 Epidemiology, clinical features, and management of severe hypercalcemia in critically ill patients | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-019-0606-8

  Severe hypercalcemia (HCM) is a common reason for admission in intensive-care unit (ICU). […] This study included all patients with a total calcemia above 12 mg/dL (3 mmol/L) admitted in two ICUs from January 2007 to February 2017. […] The use of bisphosphonates (HR, 0.42; 95% CI, 0.270.67; P0.001) was the only treatment significantly associated with a decrease of total calcemia below 12 mg/dL (3 mmol/L) at day 5. […] Early ICU admission and prompt HCM management are crucial, especially in patients with an underlying solid tumor presenting with neurological symptoms. […] Clinical symptoms are non-specific, depending on calcium levels and rapidity of onset. They include renal complications, ranging from polyuria to acute kidney injury (AKI); cardiovascular complications, including sinus tachycardia, hypertension, and infarct-like ST segment elevation; digestive events, from abdominal pain to acute pancreatitis, and neurological impairments, including seizures, delirium, and coma.

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