Clinical Medications Worksheets

Generic NameCalcium carbonate/ Vitamin D

Trade NameCalcium 600 + D

Classificationmineral and electrolyte replacements/supplements

Dose1000mg/400 IU

RoutePO

Time/frequencyqd

PeakUnknown

OnsetUnknown

Durationunknown

For IV meds, compatibility with IV drips and /or solutionsN/A

Mechanism of action and indications(Why med ordered)Mineral/electrolyte/vitamin supplement

Nursing Implications (what to focus on) Contraindications/warnings/interactions   Hypercalcemia   Renal calculi    Ventricular fibrillation Cereals , spinach , or rhubarb may decrease the absorption of

calcium supplements

Common side effectsArrhythmias, constipation

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Milk of Magnesia: Use of magnesium-containing products with a vitamin D analog may increase the risk of hypermagnesemia. Norvasc: Calcium-containing products may decrease the effectiveness of calcium channel blockers by saturating calcium channels with calcium. Lorazepam: A number of studies have reported that antacids can delay the gastrointestinal absorption and reduce the peak plasma concentration (Cmax) of some benzodiazepines, including clorazepate, chlordiazepoxide and diazepam, although the overall extent of absorption is generally not affected.

Lab value alterations caused by medicineMonitor serum calcium or ionized calcium, chloride, sodium, potassium, magnesium, albumin, and parathyroid hormone (PTH) concentrations. May cause decreased serum phosphate concentrations with excessive and prolonged use. When used to treat hyperphosphatemia in renal failure patients, monitor phosphate levels.

Be sure to teach the patient the following about this medicationInstruct patient not to take enteric-coated tablets within 1 hr of calcium carbonate; this will result in premature dissolution of the tablets. Do not administer concurrently with foods containing large amounts of oxalic acid (spinach, rhubarb), phytic acid (brans, cereals), or phosphorus (milk or dairy products). Administration with milk products may lead to milk-alkali syndrome (nausea, vomiting, confusion, headache). Do not take within 1-2 hr of other medications if possible. Instruct patients on a regular schedule to take missed doses as soon as possible, then go back to regular schedule. Advise patient that calcium carbonate may cause constipation. Review methods of preventing constipation (increasing bulk in diet, increasing fluid intake, increasing mobility) and using laxatives. Severe constipation may indicate toxicity. Advise patient to avoid excessive use of tobacco or beverages containing alcohol or caffeine.

Nursing Process- Assessment(Pre-administration assessment)Observe patient closely for symptoms of hypocalcemia (paresthesia, muscle twitching, laryngospasm, colic, cardiac arrhythmias, Chvostek's or Trousseau's sign). Notify physician or other health

AssessmentWhy would you hold or not give this med?Occurrence of unwanted side effects. Nausea, vomiting, anorexia, thirst, severe constipation, paralytic ileus, and bradycardia.

EvaluationCheck after givingIncrease in serum calcium levels.

care professional if these occur.