hello, I am trying to understand corrected calcium, and I am really confused. I understand that Ionized Ca is the only physiologically important form of Calcium, and I understand that Calcium and Albumin have an important relationship. I was taught that Ionized Ca samples aren't often not handled correctly, because they are pH dependent, therefore, it is wise to calculate a corrected Ca.To measure the corrected Ca,
(0.8*(Narmal Albumin - Pt's Albumin)) + Serum Ca
What I am not finding, is how to interpret these results. I think I understand everything else, but what do I do with the result? When do you replace Ca? I've looked in my books, online etc...If anyone can help, I'd greatly appreciate it. My Patho instructor has not been available to clarify this.
I can probably best explain it by presenting an example.
Patient W has the following lab values
Ca 7.4 mg/dL
Albumin 1.2 g/dL
Now, the question is should you replace the calcium?
The corrected calcium in this scenario = 9.64 mg/dL
Here's the formula:
Corrected calcium = (0.8 x (Normal Albumin (4.0 g/dL; 40 g/L) - Serum Albumin)) + Plasma Ca
My understanding is that you use the corrected calcium to determine if a calcium disorder needs to be treated. Essentially, you use the corrected calcium level instead of the serum calcium in your evaluation of the patient.
If the level is normal then you don't treat the hypocalcemia, such as in this case above, corrected calcium falls in the normal range.
The low measured level of serum calcium is a manifestation of low albumin levels. Your course of action should be to address the low albumin levels, nutritional status of your patient. Replacing the calcium will be of no benefit to your patient.
If the corrected calcium level is in fact low and reveals that your patient truly is hypocalcemic then your course of action would be to treat. Usually a vit D defficiency and or maybe a hypoparathyroid disorder.
Last edit by TX RN on Dec 20, '09