electrolytes

Question 1

What are electrolytes?

Answer 1

Charged particles found in intracellular fluid (ICF) and extracellular fluid (ECF)

Includes cations and anions.

Question 2

List the cations found in electrolytes.

Answer 2

• Na+
• K+
• Ca+
• Mg+
• H+

Cations are positively charged ions.

Question 3

List the anions found in electrolytes.

Answer 3

• Cl-
• Phos-
• Bicarb
• Proteins

Anions are negatively charged ions.

Question 4

What factors regulate electrolyte levels?

Answer 4

• Dietary intake
• Hormonal regulation
• ADH
• Aldosterone
• ANP
• Vitamin D and calcitonin
• Insulin & epinephrine
• Gastrin, CCK, secretin

Hormones play a crucial role in maintaining electrolyte balance.

Question 5

What are some risk factors for electrolyte imbalances?

Answer 5

• Decreased dietary intake
• Decreased availability
• Increased losses
• Increased intake and retention or decreased excretion
• Age
• Health literacy issues

These factors can lead to both deficiency and excess of electrolytes.

Question 6

What is the pathophysiology of hyponatremia?

Answer 6

Altered nerve cell excitability via impact on membrane potential, osmotic fluid shifts, change in acid/base balance (H+/K+)

Hyponatremia is defined as sodium levels < 135 meq/L.

Question 7

What are clinical manifestations of hyponatremia?

Answer 7

• Lethargy
• Difficult to focus
• Coma
• Irregular heart rhythm
• Ileus

Manifestations vary by severity and individual response.

Question 8

What is the medical management for mild hyponatremia (126-135 meq/L)?

Answer 8

Balanced diet, fluid restriction if fluid volume excess (FVE), sodium replacement if Na < 125 meq/L

Sodium replacement can be dietary or IV.

Question 9

What defines hypernatremia?

Answer 9

Sodium > 145 meq/L

Hypernatremia is often due to water loss or sodium gain.

Question 10

What are clinical manifestations of hypernatremia?

Answer 10

• Dry, cracked lips
• Warm, moist skin
• Seizures
• Hyperactivity
• Irregular heart rhythm

Symptoms are related to cellular dehydration and increased neuronal excitability.

Question 11

What is the therapeutic range for potassium?

Answer 11

3.5-5.0 meq/L

Potassium is critical for neuromuscular excitability and acid/base balance.

Question 12

What defines hypokalemia?

Answer 12

Potassium < 3.5 meq/L

Common causes include decreased intake and increased losses.

Question 13

What are clinical manifestations of hypokalemia?

Answer 13

• Muscle cramps
• Irregular heart rhythm/dysrhythmia
• Diarrhea
• U wave on the ECG

Severe hypokalemia can lead to serious cardiac complications.

Question 14

What is the medical management for hypokalemia?

Answer 14

Identify and manage cause, replete potassium, mild replacement PO, moderate to severe IV replacement diluted and on pump

Administration should not exceed 10 meq/hr.

Question 15

What defines hyperkalemia?

Answer 15

Potassium > 5.0 meq/L

Causes include renal failure and excess potassium release from injured cells.

Question 16

What are clinical manifestations of hyperkalemia?

Answer 16

• Edema
• Tall, tented T waves on ECG
• Paralytic ileus
• Asystole
• Diarrhea

These manifestations arise from altered neuromuscular excitability.

Question 17

What is the medical management for mild hyperkalemia?

Answer 17

Dietary restrictions

Management may escalate to pharmacologic interventions or dialysis for severe cases.