DRUG STUDY

Brand Name: Kalcinate Generic Name: Calcium Gluconate Drug Classification: Fluid and Electrolytic
and Water Balance Agent; Replacement Solution

Dosage, Route &

Drug-Drug & Side Effects Adverse
Frequency
Drug Action Drug-Food Indications Contraindications (By Reactions (By
Recommende Prescribe Interactions System)
System)
d d

HYPOCALCEM 2 g IV Essential for function, DRUG: Acute All preparations: Frequent: Hypercalcemia
IA infusion integrity of nervous, Hypercalcemi hypocalcemia Calcium-based PO: Chalky :
IV (Calcium now over muscular, skeletal a may (e.g., neonatal renal calculi, taste. Early signs:
Gluconate): 1 hour x systems. Plays an increase hypocalcemic hypercalcemia, Parenteral: Constipation,
ADULTS, 1 dose important role in normal digoxin tetany, ventricular Pain, rash, headache, dry
ELDERLY: 1–2 cardiac/renal function, toxicity. Oral alkalosis), fibrillation. redness, mouth,
g over 2 hrs. respiration, blood form may electrolyte Calcium chloride: burning at increased
May repeat coagulation, cell decrease depletion, Digoxin toxicity. injection thirst,
q60 min until membrane and capillary absorption of cardiac arrest Calcium site; irritability,
level resolved. permeability. Assists in biphosphonat (strengthens gluconate: flushing, decreased
May give regulating release/storage es (e.g., myocardial Neonates: nausea, appetite,
undiluted or of risedronate), contractions), Concurrent IV use vomiting, metallic taste,
may dilute hormones/neurotransmitt calcium hyperkalemia with ceftriaxone. diaphoresis fatigue,
with 100 ml ers. Neutralizes/reduces channel (reverses Cautions: , weakness,
0.9% NaCl or gastric acid (increases pH). blockers, cardiac Hepatic or renal hypotensio depression.
D5W. Rate of Therapeutic Effect: tetracycline depression), impairment, n. Later signs:
Admi Replaces calcium in derivatives, hypermagnese cardiovascular Occasional: Confusion,
Note: Rapid deficiency states; controls thyroid mia (aids in PO: Mild drowsiness,
disease, acidosis,
administration hyperphosphatemia in products. reversing CNS constipatio hypertension,
history of renal
may produce end-stage renal disease; HERBAL: depression). n, fecal photosensitivit
vasodilation, relieves heartburn, None calculi impaction, y, arrhythmias,
hypotension, indigestion. significant. peripheral nausea,
arrhythmias, FOOD: Food edema, vomiting,
syncope, may increase metabolic painful
cardiac calcium Cardiac arrest alkalosis urination.
arrest.  absorption. may occur (muscle Body
•  IV push: LAB VALUES: pain, Whole: Tinglin
Infuse slowly May increase restlessnes g sensation.
over 3–5 min serum pH, s, slow With rapid IV,
or at calcium, Constipation, respiration sensations of
maximum rate gastrin. May bloating, and gas s, altered heat waves
of 50–100 decrease may occur with taste). (peripheral
mg/min (in serum oral vasodilation),
cardiac arrest, phosphate, fainting.
administration
may potassium. GI: PO
administer Use caution in preparation:
over 10–20 Constipation,
patients with
sec). increased
severe
 IV gastric acid
infusio secretion.
Hyperphosphate
n: CV: (With
Dilute mia rapid infusion)
1–2 g hypotension,
in 100 bradycardia,
ml cardiac
Adult and
0.9% arrhythmias,
Pediatric
NaCl cardiac arrest,
or Advanced Life Skin: Pain and
D5W Support programs burning at IV
and no longer site, severe
infuse recommend venous
over 1 routine calcium thrombosis,
hr. necrosis and
for CPR
Storag sloughing
e  (with
•  Store at extravasation).
room Rapid IV infusion
temperature. associated with
•  Once hypotension,
diluted, stable
bradycardia,
for 24 hrs at
syncope, cardiac
room
temperature arrest, cardiac
arrhythmias,
sense of
oppression or
heat waves,
tingling sensation,
vasodilation

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)

 Assess B/P, EKG and cardiac rhythm, renal function, serum  Report S&S of hypercalcemia promptly to your care
magnesium, phosphate, potassium provider.
 Monitor serum BMP, calcium, ionized calcium, magnesium,
phosphate; B/P, cardiac rhythm, renal function. Monitor for signs  Milk and milk products are the best sources of calcium (and
of hypercalcemia. phosphorus). Other good sources include dark green
 Do not take within 1–2 hrs of other oral medications, fiber- vegetables, soy beans, tofu, and canned fish with bones.
containing foods.  Calcium absorption can be inhibited by zinc-rich foods: nuts,
 Avoid excessive use of alcohol, tobacco, caffeine. seeds, sprouts, legumes, soy products (tofu).
 Assess for cutaneous burning sensations and peripheral
vasodilation, with moderate fall in BP, during direct IV injection.  Check with physician before self-medicating with a calcium
 Monitor ECG during IV administration to detect evidence of supplement.
hypercalcemia: decreased QT interval associated with inverted T
wave.
 Observe IV site closely. Extravasation may result in tissue
irritation and necrosis.
 Monitor for hypocalcemia and hypercalcemia.
 Lab tests: Determine levels of calcium and phosphorus (tend to
vary inversely) and magnesium frequently, during sustained
therapy. Deficiencies in other ions, particularly magnesium,
frequently coexist with calcium ion depletion.