Assessment

Laboratory assessment
Clinical assessment
Decision to treat

A blood test is done to check the level of calcium. Other blood tests may be done to check kidney function.

Patients with high calcium levels should be examined for the following:

• Symptoms:
  • Nerves and muscles (muscle strength, muscle tone, reflexes, tiredness, indifference, depression, confusion, restlessness).
  • Heart (high blood pressure, heart changes, irregular heartbeat, digitalis poisoning).
  • Kidneys (production of too much urine, night-time urinating, sugar in the urine, excess thirst).
  • Gastrointestinal (loss of appetite, nausea, abdominal pain, constipation, abdominal bloating).
  • Other (muscle and bone pain, itching).
• History:
  • How fast did the symptoms appear?
  • Is there x-ray evidence of primary or metastatic bone disease?
  • Has the patient been taking tamoxifen, estrogen, or androgens?
  • Is the patient taking digoxin?
  • Is the patient receiving calcium in intravenous fluids?
  • Is the patient receiving thiazide diuretics, vitamins A or D, or lithium?
  • Is there another disease present that could cause dehydration or lack of movement?
  • Are there effective treatments for the patient's cancer?

The decision to treat hypercalcemia depends on the treatment goals determined by the patient, caregivers, and the physician. The natural course of untreated hypercalcemia progresses to loss of consciousness and coma. This may be preferred by some patients at the end of life who have unrelieved suffering and/or untreatable symptoms.