Patients Name:

Sex:
Name of Drug
Generic Name:
Calcium Gluconate

Brand Name:
Apo-Cal
Calci-Chew
Calcarb
Patients Dose:
1000 mg PO

Classification
Pharmacologic:
Mineral Supplements

Therapeutic:
Mineral and Electrolyte
Replacements

Diagnosis:
Age:

Date of Admission:
Height/Weight:

Mechanism of Action
Action:
Essential for nervous, muscular, and skeletal
systems. Maintain cell membrane and
capillary permeability. Act as an activator in
the transmission of nerve impulses and
contraction of cardiac, skeletal, and smooth
muscle. Essential for bone formation and
blood coagulation.

Pharmacokinetics:
ROUTE
PO
IV

ONSET
Unknown
Immediate

PEAK
Unknown
Immediate

DURATION
Unknown
0.5-2 hr

Indication
General:
Treatment and
prevention of
hypocalcemia.
Adjunct in the
prevention of
postmenopausal
osteoporosis.

Patients Indication:
Treatment and
prevention of
hypocalcemia.

Maximum Dose:
2000 mg PO
Absorption: Absorption in the GI tract
requires vitamin D.
Minimum Dose:
500 mg PO

Distribution: Readily enters extracellular

fluid. Crosses the placenta and enters breast
milk.
Metabolism & Excretion: Excreted mostly in
the feces; 20% eliminated by the kidneys.

Availability:
Tablets
Injection

Pregnancy Category:
Category C

Source:
Deglin, J. (2011) Daviss
Drug Guide for Nurses (12th
ed.) Philadelphia, FA Davis
Company pp.265-269

Half-life: Unknown.

Source:
Deglin, J. (2011) Daviss Drug Guide for
Nurses (12th ed.) Philadelphia, FA Davis
Company pp.265-269

Side Effects
CNS: syncope (IV only),
tingling.
CV: CARDIAC ARREST
(IV only), arrhythmias,
bradycardia.
F and E: hypercalcemia.

Precautions:
Patients receiving
digitalis glycosides;
Severe respiratory
insufficiency; Renal
disease;
Cardiac disease; OB:
Hypercalcemia mayqrisk
of maternal and fetal
complications; Lactation:
Breast
feeding not expected to
harm infant provided that
serum
calcium levels monitored.

GI: constipation, diarrhea

(oral solution
only), nausea, vomiting.

Source:
Deglin, J. (2011)
Daviss Drug Guide for
Nurses (12th ed.)
Philadelphia, FA Davis
Company pp.265-269

Source:
Deglin, J. (2011) Daviss
Drug Guide for Nurses
(12th ed.) Philadelphia, FA
Davis Company pp.265269

Nursing Responsibilities
Before:

Local: phlebitis (IV only).

After:

Source:
Deglin, J. (2011) Daviss
Drug Guide for Nurses
(12th ed.) Philadelphia, FA
Davis Company pp.265269

Verify doctors order

Ask for drug allergies
Assess for apical pulse for 1 full
minute before administering.
Observe the 10Rs of drug
administration
Administer the prescribed dosage

During:

GU: calculi,
hypercalciuria.

Drug Interactions:
Hypercalcemiaqthe risk
of digoxin
toxicity. Chronic use with
antacids in renal
insufficiency
may lead to milk-alkali
syndrome. Calcium
supplements, including
calcium-containing
antacids,
mayqrisk of
hypercalcemia

Route:
PO
IV

Source:
Deglin, J. (2011)
Daviss Drug Guide
for Nurses (12th ed.)
Philadelphia, FA
Davis Company
pp.265-269

Contraindication
Hypercalcemia; Renal
calculi;
Ventricular fibrillation;
Concurrent use of
calcium
supplements (calcium
acetate).

Follow oral doses with a full glass

of water
Tablets can be crushed
Do not administer concurrently
with foods containing large
amounts of oxalic acid (spinach,
rhubarb), phytic acid (brans,
cereals), or phosphorus (milk or
dairy products)
Administer on an empty stomach
before meals to optimize
effectiveness
Do not take within 12 hr of other
medications if possible.
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. Encourage patients to
maintain a diet adequate in
vitamin D
Advise patient to notify health
care professional promptly if
signs and symptoms of
hypercalcemia (constipation,
anorexia, nausea, vomiting,
confusion, stupor) occur.
Documentation

Source:
Deglin, J. (2011) Daviss Drug Guide for
Nurses (12th ed.) Philadelphia, FA Davis
Company pp.265-269