The most appropriate treatment for her now includes:
ExplanationYour patient is now presenting with a classic case of milk-alkali syndrome. The diagnosis should be recognized by the triad of hypercalcemia, metabolic alkalosis, and renal insufficiency in combination with the history of typical symptoms (described in the case), and excessive calcium carbonate ingestion. Treatment includes removal of the offending agent and treatment of the hypercalcemia with IV saline (to improve renal perfusion and metabolic alkalosis) and furosemide (since loop diuretics cause renal calcium wasting). Thiazide diuretics result in reabsorption of calcium—the opposite of what you want to achieve in a patient with hypercalcemia.
