Electrolytes Flashcards
What are electrolytes?
Positively or negatively charged inorganic molecules essential for basic life functioning
Electrolytes include potassium, sodium, calcium, phosphorus, magnesium, and chloride.
What is the normal range for sodium (Na+)?
135-145 mEq/L
A low sodium level is called hyponatremia, and a high sodium level is called hypernatremia.
What are the responsibilities of electrolytes?
- Balancing water in the body
- Balancing pH levels
- Moving waste out of cells
- Moving nutrients into cells
- Allowing proper function of muscles, heart, nerves, and brain
What is hypernatremia?
A condition where sodium levels exceed 145 mEq/L
Causes include water loss greater than sodium loss and conditions like kidney failure.
List some manifestations of hypernatremia.
- Increased thirst
- Dry mucous membranes
- Reduced skin turgor
- Fatigue
- Postural hypotension
- Tachycardia
- Irritability & restlessness
- Muscle twitching
What is hyponatremia?
A condition where sodium levels are less than 135 mEq/L
Caused by sodium loss greater than water loss or water gain greater than sodium gain.
What are early symptoms of hyponatremia?
- Nausea
- Vomiting
- Anorexia
- Abdominal cramping
- Hyperactive bowel sounds
- Headache
What is the normal range for potassium (K+)?
3.0 – 5.0 mEq/L
Low potassium is called hypokalemia, and high potassium is called hyperkalemia.
What are some causes of hypokalemia?
- Increased kidney excretion
- Increased GI excretion
- Low dietary intake
- Acid-base imbalances
- Insulin administration
What are manifestations of hypokalemia?
- Fatigue
- Confusion
- Hypotension
- Weak thready pulse
- Muscle weakness
- Shallow weak respirations
- Arrhythmias
What is hyperkalemia?
A condition where potassium levels exceed 5.0 mEq/L
Common causes include decreased kidney excretion and excessive potassium intake.
What are manifestations of hyperkalemia?
- Muscle weakness
- Flaccid paralysis
- Decreased deep tendon reflexes
- Arrhythmias
- Nausea/vomiting/diarrhea
What is the normal range for calcium (Ca+)?
8.6-10.4 mg/dL
Ionized serum calcium normal range is 4.25-5.25 mg/dL.
What are causes of hypocalcemia?
- End-stage kidney disease
- Hypoparathyroidism
- Vitamin D deficiency
- Inadequate oral intake
- Malabsorption in GI tract
What are some manifestations of hypercalcemia?
- Fatigue
- Muscle weakness
- Impaired cognition
- Polyuria
- Anorexia
- Nausea
- Vomiting
What is the normal range for magnesium (Mg+)?
1.8 – 2.6 mg/dL
Low magnesium is called hypomagnesemia, and high magnesium is called hypermagnesemia.
What are some causes of hypomagnesemia?
- Alcoholism
- GI losses
- Poor dietary intake
- Decreased absorption in GI tract
- Kidney disease
What are manifestations of hypermagnesemia?
- Hypoactive reflexes
- Drowsiness
- Muscle weakness
- Depressed respirations
- EKG changes
What is hypermagnesemia?
Elevated magnesium levels in the blood
Causes include kidney disease, overconsumption of magnesium-containing products, and certain bowel disorders.
What are the manifestations of hypermagnesemia?
Lethargy, hypoactive reflexes, drowsiness, muscle weakness, depressed respirations, EKG changes
Changes include prolonged PR & QT intervals, dysrhythmias, and potential cardiac arrest.
What is the management for hypermagnesemia?
IV calcium gluconate, ventilatory support, hemodialysis, loop diuretics
Avoid magnesium-containing medications and educate patients on their use.
What is the normal range for chloride levels?
97 – 107 mEq/L
Chloride is a major anion of extracellular fluid.
What is hypochloremia?
Serum chloride level <97 mEq/L
Can be caused by vomiting, diuretics, burns, cystic fibrosis, and metabolic alkalosis.
What are the manifestations of hypochloremia?
Agitation, irritability, weakness, hyperexcitability of muscles, dysrhythmias, seizures, coma
May present similarly to hyponatremia.
What is the management for hypochloremia?
Find underlying cause, replace chloride with IV NS or 0.45% NS, monitor I&O
Educate about high-chloride foods and avoid drinking free water.
What is hyperchloremia?
Serum chloride level >107 mEq/L
Causes include iatrogenic factors, metabolic acidosis, diarrhea, and excessive water loss.
What are the manifestations of hyperchloremia?
Extreme thirst, tachypnea, lethargy, weakness, Kussmaul respirations, hypertension, cognitive changes
May present similarly to hypernatremia.
What is the management for hyperchloremia?
Correct underlying cause, restore electrolyte balance, monitor I&O
Use hypertonic IV solutions and educate on diet and hydration.
What is the normal range for phosphorus levels?
2.7 – 4.5 mg/dL
Phosphorus works closely with calcium to maintain bone integrity.
What is hypophosphatemia?
Serum phosphorus level <2.7 mg/dL
Can occur even when total-body phosphorus stores are normal.
What are the causes of hypophosphatemia?
Alcoholism, malnutrition, refeeding syndrome, hyperparathyroidism, heat stroke, respiratory alkalosis
Major burns can also lead to hypophosphatemia.
What are the manifestations of hypophosphatemia?
Neurologic symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bone pain, increased susceptibility to infection
What is the management for hypophosphatemia?
Prevention, correct underlying cause, oral replacement with vitamin D supplement
IV phosphorus replacement is for levels <1 mg/dL.
What is hyperphosphatemia?
Serum phosphorus level >4.5 mg/dL
Generally asymptomatic but can lead to complications.
What are the causes of hyperphosphatemia?
Renal disease, excess phosphorus intake, hypoparathyroidism, overuse of vitamin D
What are the manifestations of hyperphosphatemia?
Soft tissue calcifications, symptoms occur due to associated hypocalcemia
X-rays may show abnormal bone development.
What is the management for hyperphosphatemia?
Treat underlying disorder, vitamin D preparations, calcium-binding antacids, dialysis
Monitor phosphorus and calcium levels, avoid high-phosphorus foods.
