Primary Nursing Diagnosis

Risk for ineffective airway clearance related to laryngospasm

OUTCOMES. Respiratory status: Gas exchange; Respiratory status: Ventilation; Symptom control behavior; Treatment behavior: Illness or injury; Comfort level

INTERVENTIONS. Electrolyte management: Hypocalcemia; Airway management; Anxiety reduction; Oxygen therapy; Airway suctioning; Airway insertion and stabilization; Cough enhancement; Mechanical ventilation; Positioning; Respiratory monitoring

H PLANNING AND IMPLEMENTATION Collaborative

The treatment is to increase the ingestion and absorption of calcium. When the patient is acutely hypocalcemic, generally calcium chloride or gluconate is rapidly administered IV. Give oral calcium supplements with meals but not with foods that interfere with calcium absorption, such as chocolate. Vitamin D supplements are usually given to increase the absorption of calcium. The individual with hypoparathyroidism needs a diet that is rich in calcium, low in phosphorus, and that includes a high fluid and fiber content.

During the acute phase of hypocalcemia, monitor the electrocardiogram (ECG) patterns for conduction block, the patient's respiratory status for dyspnea and stridor, and the central nervous system for seizure activity. Alkalosis worsens the symptoms of hypocalcemia because more free calcium binds with proteins when the blood pH increases. Strategies that increase carbon dioxide retention, such as breathing into a paper bag or sedating the patient, can control muscle spasm and other symptoms of tetany until the calcium level is corrected.

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