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


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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