Certified Wound Ostomy Nurse (CWON) Practice Test

What laboratory abnormalities increase the risk of calciphylaxis?

1. Hypokalemia and hyperglycemia

2. Hypocalcemia and hyponatremia

3. Hypercalcemia and hyperphosphatemia

4. Elevated white blood cell count and anemia

The correct answer is: Hypercalcemia and hyperphosphatemia

Calciphylaxis, a serious and often fatal condition primarily associated with chronic kidney disease, involves the calcification of blood vessels and resulting tissue ischemia. The correct answer points to hypercalcemia and hyperphosphatemia as significant risk factors for calciphylaxis. When hypercalcemia (elevated calcium levels) and hyperphosphatemia (elevated phosphate levels) occur simultaneously, they create a perfect environment for the precipitation of calcium phosphate in the vascular system. This process leads to tissue ischemia and necrosis, characteristic of calciphylaxis. In individuals with compromised kidney function, the kidneys struggle to excrete excess phosphate, leading to increased phosphate levels. When calcium levels also rise as a result of various factors, including vitamin D supplementation, this combination greatly enhances the risk of calciphylaxis. Other options present laboratory abnormalities that have less direct association with the pathophysiology of calciphylaxis. For instance, hypokalemia and hyperglycemia are not inherently linked to the calcification of vascular structures. Similarly, while hypocalcemia and hyponatremia might signal other metabolic disturbances, they do not contribute to the hypercalcemic state that, in conjunction with hyperphosphatemia,