NCLEX-RNPhysiological AdaptationEasy
A client with metastatic breast cancer has a serum calcium level of 12.5 mg/dL. Which additional finding should the nurse expect during assessment?
- ADecreased deep tendon reflexes
- BPositive Trousseau's sign
- CMuscle cramps and tetany
- DHyperactive bowel sounds
Show answer & explanationAnswer & explanation
Correct answer: A. Decreased deep tendon reflexes
Hypercalcemia depresses neuromuscular excitability, causing decreased deep tendon reflexes, muscle weakness, constipation, and confusion. Trousseau's sign, tetany, and hyperactive bowel sounds are findings associated with hypocalcemia, the opposite imbalance.
Why the other options are wrong
- B. Trousseau's sign indicates hypocalcemia-induced neuromuscular irritability, not hypercalcemia.
- C. Tetany and cramps occur with hypocalcemia, not hypercalcemia.
- D. Hypercalcemia decreases bowel motility, causing constipation and hypoactive, not hyperactive, bowel sounds.
Hypercalcemia
Elevated serum calcium (>10.5 mg/dL) depresses neuromuscular and GI activity, causing weakness, constipation, confusion, and decreased reflexes.
- Common causes: cancer/bone metastasis, hyperparathyroidism, immobility
- Signs: decreased DTRs, constipation, polyuria, confusion
- Opposite findings (tetany, hyperreflexia) occur in hypocalcemia
Memory trick: High calcium = everything slows down