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

U PLANNING AND IMPLEMENTATION Collaborative

If the patient has an airway obstruction, endotracheal intubation and mechanical ventilation may be needed to manage laryngospasm. Hypocalcemia is treated pharmacologically. Acute hypocalcemia with tetany is a medical emergency that requires parenteral calcium supplements. Be aware of factors related to the administration of calcium replacement. A too-rapid infusion rate can lead to bradycardia and cardiac arrest; therefore, place patients who are receiving a continuous calcium infusion on a cardiac monitor, and place the infusion on a controlled infusion device. The infusion rate should be adjusted to avoid recurrent symptomatic hypocalcemia and to maintain serum calcium levels between 8 and 9 mg/dL. Monitor the patient's serum calcium levels every 12 to 24 hours, and immediately report a calcium deficit less than 8.5 mg/dL. When giving calcium supplements, frequently check pH levels because an alkaline state (pH < 7.45) inhibits calcium ionization and decreases the free calcium available for physiological reactions.

Chronic hypocalcemia can be treated in part by a high dietary intake of calcium. If the deficiency is caused by hypoparathyroidism, however, teach the patient to avoid foods high in phosphate. Vitamin D supplements are prescribed to facilitate gastrointestinal calcium absorption.

Pharmacologic Highlights

Medication or

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