Assessment
Laboratory assessment
Clinical assessment
Decision to treat
Laboratory assessment
A blood test is done to check the level of calcium. Other blood tests may be
done to check kidney function.
Clinical assessment
Patients with high calcium levels should be examined for the following:
- Symptoms:
- Nerves and muscles (muscle strength, muscle tone, reflexes, tiredness,
indifference, depression, confusion, restlessness).
- Heart (high blood pressure, heart changes, irregular heartbeat, digitalis
poisoning).
- Kidneys (production of too much urine, night-time urinating, sugar in the
urine, excess thirst).
- Gastrointestinal (loss of appetite, nausea, abdominal pain, constipation,
abdominal bloating).
- Other (muscle and bone pain, itching).
- History:
- How fast did the symptoms appear?
- Is there x-ray evidence of primary or metastatic bone disease?
- Has the patient been taking tamoxifen, estrogen, or androgens?
- Is the patient taking digoxin?
- Is the patient receiving calcium in intravenous fluids?
- Is the patient receiving thiazide diuretics, vitamins A or D, or lithium?
- Is there another disease present that could cause dehydration or lack of
movement?
- Are there effective treatments for the patient's cancer?
Decision to treat
The decision to treat hypercalcemia depends on the treatment goals determined
by the patient, caregivers, and the physician. The natural course of untreated
hypercalcemia progresses to loss of consciousness and coma. This may be
preferred by some patients at the end of life who have unrelieved suffering
and/or untreatable symptoms.
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