Electrolyte Imbalance Flashcards
Sodium (Na+) Range
136 - 145 mEq/L
Sodium Facts
Most Abundant Cation in ECF
Essential for nerve impulse transmission/muscle contraction
Hyponatremia Causes
<136
- Fluid Overload
- Psychogenic polydipsia (too much thirst)
- Adrenal Insufficiency (Adrenals secrete Aldosterone)
- SIADH
- Diuretic Therapy
- Liver Disease
Hyponatremia S/S
- Headache (CNS problems)
- Nausea; diarrhea, abdominal cramps
- Tachycardia; hypotension
- muscle weakness
- dry skin; pale dry mucous membranes
Treatments for Hyponatremia
- IV of 0.9% NS
- Hypertonic saline given with dangerously low Na+ levels.
- No free water intake
Hypernatremia Causes
> 145
- dehydration
- greatly increased sensible water loss
- severe watery diarrhea
- Insufficient ADH
- Kidney disease
- Excess secretion of aldosterone
Hypernatremia S/S
S- skin flushed A- agitation L- low fever T- thirst D- Dry sticky mucous membrance; oliguria
Treatmentment for Hypernatremia
- Hypotonic saline solution such as 0.45% NS
- Diuretics
- Na+ resrictions
Potassium Range
3.5 - 5.0 mEq/L
Potassium Facts
- Most abundant Cation in ICF
- Responsible for regular heart rhythm
- Aids in protein synthesis
- Aids in conversion of glucose to energy
- Regulation of Acid-base balance
- conduction of neuromuscular impulses.
Foods high in potassium
bananas, meat, potatoes, citrus fruits, avacados
Foods low in potassium
Eggs, Bread and Cereal grains
Hypokalemia Causes
<3.5
- fluid overload
- diuretic therapy
- GI losses (vomiting or NG suction)
- Insufficient GI absorption
- Abnormal losses of secretions or excretions.
Hypokalemia S/S
S-skeletal muscle weakness U- U wave;EKG changes C- constipation; ileus; decreased bowel sounds T-toxic effects of digoxin I-Irregular, weak pulse O-orthostatic hypotension N- numbness(paresthesia)
Treatment of Hypokalemia
- Increase in potassium in diet
- Administer potassium (oral/IV)
Hyperkalemia Causes
> 5
- dehydration
- kidney disease
- acidosid
- adrenal insufficiency
- massive crushing injuries
Hyperkalemia S/S
- Early symptoms are not specific
- First tachycardia, later bradycardia
- Tall, peaked T wave on EKG
- Risk for cardiac arrest
- Muscle cramps
- Nausea, diahrrea
- paresthesia of face, tongue, and extremities
Treatment of Hyperkalemia
- Avoid K+ intake
- Give kayexalate
- Give lasix
- If acute, hive hypertonic IV solutions of D5 of D1/4 with IV regular insulin
- In severe cases Ca++ to stimulate heart
Calcium (Ca++) Range
9.0 - 10.5 mEq/L
Calcium Facts
- 99% stored in bone
- 0.5% bound with protein in plasma
- regulates cell permeability to Na+ and K+
- Important for transmission of nerve impulses
- Contraction of muscle tissue, maintain normal heart rhythm
- blood clotting process
- absorption and utilization of B12
- Levels regulated by PTH
Hypocalcemia Causes
<9.0
- Removal of parathyroid glands
- Increased loss of intestinal secretions
Hypocalcemia S/S
- Neuromuscular irritability
- Carpopedal spasms (Trousseaus Sign)
- Facial twitches (chvostek’s sign)
- EKG changes, Heart failure
Treatment of Hypocalcemia
- Adjust diet
- Oral or IV calcium
- Vitamin D oral or IM
Hypercalcemia Causes
> 10.5
- Parathyroid tumor
- Excessive vitamin D administration
- Multiple fractures
- Prolonged immobilization or bed rest
Hypercalcemia S/S
- fatigue, lethargy
- decreased muscle tone/weakness
- deep bone pain, kidney stones, confusion
- N/V, thirst, constipation
Treatment of Hypercalcemia
-IV fluids to dilute Ca++, Lasix to force diuresis
Magnesium (Mg++) Range
1.3 - 2.1 mEq/L
Magnesium Facts
- Found in ICF
- regulated by parathyroid glands
- essential for enzyme activities, neurochemical activities, muscular excitability
Hypomagnesemia causes
<1.3
- Inadequate intake, excessive loss
- Inadequate absorption
- Hypoparathyroidism
Hypomagnesemia S/S
- weakness, tremors, muscle cramps
- N/V, esophageal spasms
- hyperactive deep tendon reflexes
- confusion; tachycardia, HTN
Treatment of Hypomagnesemia
Dietary replacement, antacids, IV or Im. Oral may cause diarrhea
Hypermagnesemia Causes
> 2.1
- Renal insufficiency
- Severe dehydration with oliguria
- Magnesium based laxatives/cathartics (eg.MOM)
Hypermagnesemia S/S
- Depressed deep tendon reflexes
- Depressed respirations, hypotension
- Sense of warmth
Treatment of Hypermagnesemia
Correct underlying cause, Dialysis may be necessary.
Chloride (Cl-) Range
98 - 106 mEq/L
Chloride Facts
- Major anion in ECF
- Componenet of hydrochloric acid
- Role of transport of carbon dioxide by RBCs
- Excreted by kidney
- Affected by aldosterone secretion
- Sodium and chloride are closely linked; a change in level of one causes a change in level of the other
Hypochloremia Causes
<98 mEq/L
- Fluid overload
- Excessive vomiting, diarrhea
- Lost with Na+ in diuretic therapy
Hypochloremia S/S
Same as hyponatremia
Treatment of Hypochloremia
IV replacement
Hyperchloremia Causes
> 106 mEq/L
- will occur with hypernatremia
- Metabolic acidosis
- Respiratory alkalosis
- Hyperalsodteronism
Hyperchloremia S/S
- Lethargy, weakness, confusion, stupor
- Deep, labored respiration
- Associated with acid-base imbalance
Treatment of hyperchloremia
IV sodium bicarbonate to reverse acidosis
Phosphate (PO4) Range
3.0 - 4.5 mg/dL
Phosphate facts
- levels vary inversely with Ca++ levels
- parathyroid hormone inhibits absorption
- promotes normal neuromuscular action
- carbohyrate metabolism
- assists in acid-base regulation
- blood buffer!
Hypophosphatemia Causes
<3.0
- Inadequate intake
- poor absorption
- loss by diuretics
- hyperparathyroidism
Hypophosphatemia S/S
Same as hypercalcemia
Treatment of Hypophosphatemia
- Oral sodium phosphates and potassium phosphates
- dietary intake
Hyperphosphatemia Causes
> 4.5
- Renal failure
- hypoparathyroidism
Hyperphosphatemia S/S
Same as hypocalcemia
Treatment of Hyperphosphatemia
- Dietary restriction
- Administering phosphate binding agent (PhosL0)
- all on for dialysis.
