NR 530 Week 1 Discussion Forum Prompt 1

Select one of the following discussion prompts to address:

Analyze how calcium and phosphate are hormonally regulated and describe the pathophysiology, clinical manifestations, evaluation and treatments for hypercalcemia and hypocalcemia.
Describe the clinical manifestations, similarities, and differences of the following vitamin deficiencies: niacin, riboflavin (B2), thiamine (B1), folate, vitamin B12, vitamin B6, pantothenic acid (B5), biotin, vitamin C, vitamin K, vitamin E, vitamin A, and vitamin D.
Describe the pathophysiology, clinical manifestations, evaluation, and treatment of metabolic acidosis and metabolic alkalosis. Discuss how and when each of the buffer systems responds to compensate/correct for acid-base imbalances.

Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.

NURS 530 Week 1 Discussion 1 SOLUTION

Analyze how calcium and phosphate are hormonally regulated and describe the pathophysiology, clinical manifestations, evaluation, and treatment for hypercalcemia and hypocalcemia.

Calcium and phosphate play a significant role in human physiology, including neuromuscular functions. According to Shaker & Deftos (2018), calcium is essential in cell signaling, neural transmission, blood coagulation, secretion, and muscle function. In the same vein, phosphate facilitates muscle contraction, membrane stabilization, and cell signaling (Sun et al., 2020). Although these ions are profound in streamlining physiological processes, they must be in proper concentrations. Various hormones regulate calcium and phosphate to maintain the correct levels. Shaker & Deftos (2018) contend that parathyroid hormone (PTH) and vitamin D regulate calcium and phosphate metabolisms. Fibroblast growth factor 23 (FGF 23) and calcitonin (CT) are other hormones that regulate calcium and phosphate. The regulation mechanism entails decreasing the expression of NaPi2a and NaPi2c, resulting in decreased tubular reabsorption. PTH and vitamin D act in the bone, kidney, and GI tract to increase serum calcium and reduce bone resorption.

The hormonal failure to regulate calcium and phosphate results in various conditions, including hypercalcemia and hypocalcemia. Hypercalcemia occurs amidst higher-than-normal levels of calcium in the blood. The clinical manifestations of this condition entail multiple symptoms, including fatigue, headaches, nausea, vomiting, constipation, and decreased appetite. The primary causes of hypercalcemia are increased calcium absorption from the gut and excess bone resorption emanating from hyperthyroidism (the creation of high amounts of PTH in the bloodstream). Routine blood tests can reveal a high level of blood calcium. On the other hand, blood tests can show levels of PTH, indicating hyperparathyroidism (Sadiq et al., 2022). The recommended treatment for hypercalcemia includes medications like calcitonin, bisphosphonates, prednisone, fluids, and diuretics.

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Similarly, hypocalcemia is a condition that emanates from hormonal failure to regulate calcium levels. The pathophysiology of hypocalcemia entails resistance to parathyroid hormone (PTH) in the bone and kidneys, alongside decreased PTH secretion (Goyal et al., 2022). This condition manifests through muscle cramps, brittle nails, scaly skin, confusion, irritability, depression, and hallucinations. Clinicians can evaluate hypocalcemia by testing the total serum (blood) calcium (≤8.8 mg/dl). Other tests for hypocalcemia include electrocardiogram (EKG) and bone imaging tests (Cleveland Clinic, 2022). Upon hypocalcemia diagnosis, healthcare professionals can embark on various pharmacologic treatment interventions. Medications for treating hypocalcemia are oral calcium pills, IV calcium gluconate, the synthetic form of PTH, and vitamin D supplement.

References

Cleveland Clinic. (2022). Hypocalcemia: Causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/23143-hypocalcemia

Goyal, A., Singh, S., Anastasopoulou, C., & Ngu, M. (2022). Hypocalcemia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430912 /

Shaker, J. L., & Deftos, L. (2018). Calcium and phosphate homeostasis. PubMed. https://www.ncbi.nlm.nih.gov/books/NBK279023/#

Sun, M., Wu, X., Yu, Y., Wang, L., Xie, D., Zhang, Z., Chen, L., Lu, A., Zhang, G., & Li, F. (2020). Disorders of calcium and phosphorus metabolism and proteomics/metabolomics-based research. Frontiers in Cell and Developmental Biology, 8. https://doi.org/10.3389/fcell.2020.576110