Electrolytes

Electrolytes

1. Sodium

   • Hypernatremia
     • >145 R/t increased sweating,poor intake, DI
     • Low BP, Dry mucous membranes, UO <30mL/hr,Disoriented, irritable
       • Tx:NS-o.5 NS. Decrease NA slowly to prevent cerebral edema
     • >145
     • Profuse sweating, poor intake, DI
       • FVD
   • Hyponatremia
     • Increased BP, potential cerebral edema,FVE,Weakness, hemiparesia, ataxia, muscle cramps, Taste changes, confusion.
       • Fluid restriction or NS- depends on cause
     • <136
       • IV dextrose, poly dispsia, SIADH
   • 135-146mEq.L

2. Chloride

   • Chloride follows sodium. Tx sodium-->Tx chloride
   • 96-110mEq/l

3. Potassium

   • Hyperkalemia
     • EKG changes, cardiac arrest, muscle weakness, flaccid paralysis, nausea
       • Tx: Bicarb, IV dextrose/insulin, kayelexate
         • NEVER GIVE k+ as IVP
           • ALWAYS KNOW PTS POTASSIUMS LEVELS BEFORE ADMIN
             • CARDIAC MONITORING IF GIVING GREATER THAN 20 MeQ/HR& ICU
     • >5.5mEq
     • Too much replacement, trauma, renal failure
   • 3.5-5mEq/L
   • HypoKalemia
     • <3.5mEq
       • GI/Renal loss; K+ shifting intracellulary b/c of glucose or alkalosis
         • Fatigue, muscle weakness, slow reflexes, flaccid parralysis, Cardiac arrythmias, N/V
           • Tx- Replacement

4. Calcium

   • 9.0-10.5 mEq/L
   • Hypercalcemia
     • Lethargy, Confusion, Muscle weakness, nausea
       • Tx: IVF, furosemide
     • Hyperparathyroidism
     • Too Many calcium antacids
     • Cancers- esp.Bone
     • >10.5mEq/L
   • Hypocalcemia
     • Trousseaus sign-palmar flexion. Chvosteks sign- cheek
     • >8.5mEq/L
     • Hypoparathyroidism,lack of vit. d, citrate in blood products
   • 9.0-10.5mEq/l

5. Magnesium

   • 1.3-2.1mg/dL

6. Phosphorus

   • 3.0-4.5mg/Dl