A. Initial Management. Treat severe hypocalcemia associated with tetany or seizures first, as described in Chapter 46, Hypocalcemia, p. 221. Correct hypocalcemia only until acute symptoms resolve, then focus on lowering phosphorus level to avoid precipitating calcium and phosphorus in soft tissues. Management may vary, depending on acuteness of patient's condition and whether renal function is normal. In conditions associated with tissue breakdown (eg, tumor lysis), address other abnormalities, such as hyperkalemia and acidosis.

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