hypocalcemia question

[skulskcc01]

If a patient has hypocalcemia would you administer thiazide diuretics or vitamin d?

I know vitamin d facilitates calcium absorption. I also know thiazide diuretics can raise serum calcium. So wouldn't they both raise serum calcium? I feel like I am over thinking this question and the answer is vitamin d. But, why would that be more right than the thiazide diuretic?

[Al.ginger]

I go with Vit D. Diuretic my mess up other lytes. Which can already be in the boarder line. Why pt. has a hypocalcemia?

[skulskcc01]

The question didn't state any addition info. It just said patient has hypocalcemia which of the following do you think md would have ordered? My gut told me vitamin d but yesterday I looked up what a thiazide diuretic did which made me over think the question and I went with that. Stupid me, I need to trust my first instinct.

[AgentBeast, MSN, RN]

A thiazide diuretic is more a long term therapy particularly in post menopausal women with osteoporosis. You'd probably see a calcium supplement along with vitamin D ordered for a more acute hypocalcemia.

[skulskcc01]

I know, I know. I realize my mistake and from this day forward I will not doubt my first answer. hah

[AgentBeast, MSN, RN]

You also might see something like aluminum hydroxide ordered. It's a phosphate binder and as you know phosphate and calcium are inversely related as one goes up the other goes down. So you'll lower the phosphate levels and at the same time raise the calcium levels. This is pretty common in renal dialysis patients.

[nurseprnRN, BSN, RN]

i'm thinking calcium gluconate, especially if it's a fresh thyroidectomy patient (laryngeal stridor and crampy fingers...classic, classic question you'll see in nclex). or were those the only two choces they gave you?