Pharmacology Electrolytes #3

Question

The nurse is administering calcium gluconate to a client experiencing laryngeal spasms and exhibiting a positive Chvostek sign. Which condition is most likely related to these symptoms and the need for immediate IV calcium gluconate?

Answers

  1. Hypothyroidism
    • Rationale:

      This answer is not correct because low thyroid levels do not affect calcium levels in the body. In hypoparathyroid, there is less parathyroid hormone, thus decreasing levels of calcium, or hypocalcemia. Symptoms of hypocalcemia include tetany (positive Chvostek and Trousseau sign) and laryngeal spasms. Since hypocalcemia resulting in laryngeal spasms is affecting the airway and breathing, the healthcare provider will order stat IV calcium gluconate.

  2. Hyperthyroidism
    • Rationale:

      This answer is not correct because elevated thyroid levels (hyperthyroidism) do not affect calcium levels in the body. In hypoparathyroid, there is less parathyroid hormone, thus decreasing levels of calcium, or hypocalcemia. Symptoms of hypocalcemia include tetany (positive Chvostek and Trousseau sign) and laryngeal spasms. Since hypocalcemia resulting in laryngeal spasms is affecting the airway and breathing, the healthcare provider will order stat IV calcium gluconate.

  3. Hypoparathyroidism
    • Rationale:

      This answer is correct because the parathyroid hormone regulates calcium in the body, therefore, in hypoparathyroid, there is less parathyroid hormone, thus decreasing levels of calcium, or hypocalcemia. Symptoms of hypocalcemia include tetany (positive Chvostek and Trousseau sign) and laryngeal spasms. Since hypocalcemia resulting in laryngeal spasms is affecting the airway and breathing, the healthcare provider will order stat IV calcium gluconate.

  4. Hyperparathyroidism
    • Rationale:

      This answer is not correct because hypoparathyroidism, not hyperparathyroidism has a decreased level of parathyroid hormone, thus decreased levels of calcium. Symptoms of hypocalcemia include tetany (positive Chvostek and Trousseau sign) and laryngeal spasms. Since hypocalcemia resulting in laryngeal spasms is affecting the airway and breathing, the healthcare provider will order stat IV calcium gluconate.

Overview

Hypoparathyroidism causes hypocalcemia. If a client is experiencing laryngeal spasms and exhibiting a positive Chvostek sign, there is a need for immediate IV calcium gluconate.

Explanation

Learning Outcomes

Hypoparathyroidism is a condition where there is a decrease in parathyroid hormone. The parathyroid hormone regulates calcium in the body. The more parathyroid hormone, the more calcium in the body. In hypoparathyroid, there is less parathyroid hormone, thus decreasing levels of calcium, or hypocalcemia. Symptoms of hypocalcemia include tetany (positive Chvostek and Trousseau sign) and laryngeal spasms. Since hypocalcemia resulting in laryngeal spasms is affecting the airway and breathing, the healthcare provider will order stat IV calcium gluconate.

Test Taking Tip

When a question has various hyper- and hypo- states listed as answers, it is best to not get lost in all the hypos and hypers. Remain calm and decide what you answer is BEFORE getting lost in the jungle of “hypos and hypers”. This keeps your mind clear and you answer the question as if it is a fill-in-the-blank.

Video Rationale