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Hypercalcemia Effects And Treatment For Palliative Care Patient

1487 words - 6 pages

Hypercalcemia49-year-old lady with 13-year history of ca breast with known bone and lung metastasis is admitted with increased confusion, constipation and increasing pain.Mary had been living independently with her adult son.Her treatment and therapies so far had includedBilateral mastectomies with axillary clearanceRadiotherapyChemotherapyIntraehteal pump for pain reliefMonthly APDHormone therapyHYPERCALCEMIA, a common life-threatening disorder, occurs in approximately 10%-20% of individuals with cancer (Chisholm). Occurrences of hypercalcemia have been reported in most types of malignancies with the most frequently reported tumours including carcinomas of the breast, lung and multiple myeloma. Immediate management of cancer-related acute hypercalcemia to prevent death or provide symptomatic relief may be warranted. With proper use of antihypercalcemic agents, the severe consequences of acute hypercalcemia can be prevented.Calcium is the most common mineral found in the body. Calcium in the body is found predominantly in bone and teeth 99% while the remainder is found in extra cellular fluid. There are a number of roles of calcium in the body:StructureCalcium is a major structural element in bones and teeth. The mineral component of bone consists mainly of hydroxyapatite crystals, which contain large amounts of calcium and phosphorus (about 40% calcium and 60% phosphorus) (Heaney).Bone is a dynamic tissue that is remodelled throughout life. Bone cells called osteoclasts begin the process of remodelling by dissolving or resorbing bone. Bone-forming cells called osteoblasts then synthesize new bone to replace the bone that was resorbed. During normal growth, bone formation exceeds bone resorption.Intracellular messengerCalcium plays a role in mediating the constriction and relaxation of blood vessels (vasoconstriction and vasodilation), nerve impulse transmission, muscle contraction, and the secretion of hormones.Excitable cells, such as skeletal muscle and nerve cells, calcium channels in their cell membranes that allow for rapid changes in calcium concentrations. For example, when a muscle fiber receives a nerve impulse that stimulates it to contract, calcium channels in the cell membrane open to allow a few calcium ions into the muscle cell. These calcium ions bind to activator proteins within the cell that release a flood of calcium ions from storage vesicles inside the cell. The binding of calcium to the protein, troponin-c, initiates a series of steps that lead to muscle contraction (Weaver)Regulation of CalciumMaintenance of the body Ca stores and plasma Ca concentration ultimately depends on dietary Ca intake, absorption of Ca from the GI tract, and renal Ca excretion.When blood calcium decreases, calcium-sensing proteins in the parathyroid glands send signals resulting in the secretion of parathyroid hormone (PTH). PTH stimulates the conversion of vitamin D to its active form, calcitriol, in the kidneys. Calcitriol increases the...

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