Electrolyte Imbalance Flashcards
What is the role of electrolytes?
- creates the action potential of cells
- creates osmotic gradient for fluid balance
What are the 2 conditions affecting Na?
hyponatremia and hypernatremia
- sodium is primarily ECF
What are the normal Na levels?
(hyponatremia) 135-145 (hypernatremia)
Etiology or cause of hyponatremia?
- Excessive loss of NA = sweating
- Excessive gains in extracellular bodily fluid = excess ADH
- inadequate na intake = diet
- diuretic therapy = increase urination so increases loss of NA in urine
- Administration of hypotonic fluids to replace fluid losses = see too much free water
What does hyponatremia cause?
- Shift of h20 from ECF to ICF
- cellular swelling
- adaptive decreases in thirst and ADH secretion
What are some clinical manifestations of hyponatremia?
- Related to neurologic dysfunction induced by hypotonic condition = serum osmolality falls → water enters brain cells (intracellular fluid shift)
- Central nervous system response: headache, confusion, stupor, coma
- Muscle cramps or weakness and spasm, seizures
- Abdominal cramping, vomiting, diarrhea
What causes Hypernatremia?
- Excessive gain in na RARE b/c of kidneys deal with eimination
- loss of free water
What does Hypernatremia cause?
- shift of water from ICF to ECF
- cellular dehydration
What are some clinical manifestations of Hypernatremia?
- Shrinkage of brain cells
- nervous system irritability: headache, confusion, sezures
- altered cellular metabolism
- increased thirst, dry mucous membranes as fluid shifts
What are the 2 disorders related to K?
Hypokalemia and hyperkalemia
- PRIMARILY ICF key component of Action potentials
What is hypokalemia caused by?
- decreased K+ intake
- shift of extracellular potassium into cells = can occur with alkalosis
What are the normal levels of K?
hypokalemia 3.5-5.0 hyperkalemia
What does hypokalemia cause?
- altered membrane potentials excitability
- ventricular repolarization delayed
What are some clinical manifestations of hypokalemia?
cardiovascular = rhythm abnormalities
neuromuscular = postural hypertension - change of bp based on position = decreased tone and fatigue
gastrointestinal = abdominal distension and constipation
What causes Hyperkalemia?
- Increased intake of K+
- mechanical disruption of cell membrane and K+ leaks out
- insufficient renal excretion of K+ = renal failure
What does hyperkalemia Cause?
Alterations in the membrane potentials and excitability = can be fatal
- increased rate of depolarization
What are some clinical manifestations of hyperkalemia?
cardiovascular
- = rhythm abnormalities, cardiac arrest, ventricular contraction
neuromuscular
- paresthesia = numbness or tingling, cramps decreased function
gastrointestinal cramping or diarrhea
What are the normal levels of Calcium?
hypocalcemia 8.5 - 10.5 hypercalcemia
What causes hypocalcemia?
- impaired ability to mobilize Ca from bone
- decreased intake or absorption
- increased renal losses = renal failure = loss of ca in urine
- inadvertent removal or injury to parathyroid glands during thyroid surgery
What does hypocalcemia cause?
- altered neurotransmission = increased excitability of muscle cells
- shortens repolarization of cardiac cells = rhythm problems
What are some clinical manifestations of hypocalcemia?
neuromuscular:
- paresthia = numbness or tingling
- skeletal muscle and abdoninal cramps
- hyperactive reflexes
- severe = sezures and tenany
- chvostek sign = LATE SIGN (facial twitching)
- trousseau’s = carpopedal spasm
Cardiovascular
- heart rate decreases
- hypotension (failure to respond to drugs
- ventricle rhythm problems
Skeletal Chronic deficiency
- bone pain, fractures
= occurs in kids bone development
What are some causes of hypercalcemia?
- primary hyperparathyroidism = maybe tumor
- increased intestinal or bone reabsorption
- decreased excetion = kidney disease
What does hypercalcemia cause?
Decreased neuromuscular irritability
What are some clinical manifestations of hypercalcemia?
- precipitation of Ca = increased risk for kidney stones
- Flank pain
cardiovascular - hypertension
- heart blocks = blockage of Av node
Gastrointestinal - nausea, vomiting, and constipation
What are the normal levels for Mg?
Hypomagnesium 1.5- 2.5 hypermagnesium
What causes hypomagnesium?
- Decrease intake or absorption in K and Ca
- increased loss kidney disorders
What does hypomagnesemia cause?
increased neromuscular and cardiac irritability
What are some clinical manifestations of hypomagnesemia?
- Ataxia = lack of voluntary coordination problems, muscle spasms, seizures
cardiovascular - ventricular rhythm problems, hypertension
What causes hypermagnememia?
- decreased renal function excretion
- increased intravenous or oral intake
What are some clinical manifestations of Hypermagnesemia?
Neuromuscular
- lethargy, decreased reflexes, muscle weakness confusion
cardiovascular
- cardiac arrest, hypotension, bradycardia
