NORCET 6 mains-2024
Pharmacology
Medium
Which of the following option is correct about calcium gluconate injection, EXCEPT?
Appeared in: NORCET 6 mains-2024
Explanation
- The question asks to identify the incorrect method of administering calcium gluconate.
- Rapid IV bolus is an unsafe and contraindicated practice for calcium gluconate administration.
- Giving IV calcium too rapidly can precipitate severe hypercalcemia, leading to cardiac irregularities, delirium, and even coma or cardiac arrest.
- Therefore, 'Rapid IV bolus' is the exception among the given options and the correct answer.
Why Other Options Were Wrong
- Option B: This is a correct and recommended practice. Diluting calcium gluconate in a compatible IV fluid helps to reduce its concentration, minimizing the risk of venous irritation and tissue damage from extravasation.
- Option C: This is a correct and essential practice. Slow administration prevents a sudden, dangerous spike in serum calcium levels, thereby avoiding adverse cardiac effects like bradycardia and hypotension.
- Option D: This is a correct and often preferred method, especially for non-emergent situations. Infusing the dose over a longer period, such as an hour, allows for a gradual and safer correction of calcium levels.
Related Visual
- Visual 1: Diagram: Comparing a rapid IV push (bolus) with a slow IV infusion setup, highlighting the use of an infusion pump for control.
- Visual 2: Infographic: Listing the signs and symptoms of IV infiltration/extravasation (swelling, pain, coolness, redness) and the immediate nursing actions.
- Visual 3: ECG Strip: Showing bradycardia and a shortened QT interval, which can be associated with hypercalcemia from rapid infusion.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Safe administration of IV calcium gluconate as background academic context rather than a clinical decision trigger.
- Patient safety is paramount. Knowing that rapid IV push of calcium is contraindicated can prevent a life-threatening medication error.
- The nurse is responsible for ensuring IV patency before and during administration of a vesicant like calcium to prevent severe tissue necrosis.
- What if the patient has severe, symptomatic hypocalcemia with tetany? Even in this emergency, the administration must be slow and controlled (e.g., over 10-20 minutes), not a rapid bolus, while the patient is on a cardiac monitor.
How to Approach the Question
- First, identify the core subject: the administration of calcium gluconate injection.
- Next, notice the keyword 'EXCEPT'. This means you are looking for the option that is an incorrect statement or a contraindicated action.
- Evaluate each option based on standard nursing practice for IV medication.
- Think: Is 'Rapid IV bolus' a safe way to give calcium? Is it given 'Diluted'? Is it given 'Slow'? Is it given 'Over 1 hour'?
- Recall or deduce that giving potent electrolytes like calcium rapidly is dangerous. This makes 'Rapid IV bolus' the likely incorrect practice.
- Confirm that dilution, slow administration, and infusion over time are all established safety measures. Since these three are correct practices, the one that is the exception must be the answer.
Concept Tested & Keywords
- Concept Tested: Safe administration of IV calcium gluconate
- Stem keywords: calcium gluconate, injection
- Lead-in keywords: EXCEPT
- Negative lead-in flag: This question uses negative framing (EXCEPT), asking you to identify the incorrect statement about the procedure.
Question ID
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Practise the full NORCET 6 mains-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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