Unit 8 Electrolyte Imbalance

Sodium

(135-145 mEq/L)

Sodium deficit in ECF

Caused by loss of sodium or gain of water; vomiting, diarrhea, fistual formation, sweating, diuretics

confusion, hypotension, edema, muscle cramps, weakness, dry skin and seizures are all signs of

excess sodium in ECF

Caused by excess water loss or excess sodium

Fluid deprivation (not being able to drink), lack of fluid consumption, diarrheat, hyperventilation, and burns

Restlessness, weakness, disorientation, delusion, and hallucinations are all signs of

(3.5-5 mEq/L)

K

Potassium deficit in ECF; <3.5 mEq/L

Lost through vomiting, gastric suction, diarrhea,
diuretics

Muscle weakness, leg cramps, fatigue, paresthesias,
dysrhythmias

Excess of potassium in ECF; >5.0 mEq/L

Renal failure, medications- KCL, potassium-sparing
diuretics

Skeletal muscle weakness, paralysis, cardiac arrest

Occurs less frequently than hypokalemia, but more
dangerous

Ca

(8.9-10.1 mg/dL)

Calcium deficit in ECF

Inadequate calcium intake, impaired calcium absorption, excessive calcium loss

Numbness and tingling of fingers, mouth, or feet,
seizures, tetany- muscle cramps & spasms; Serum calcium < 8.9mg/dL

Excess of calcium in ECF

Cancer and hyperparathyroidism; Serum calcium > 10.1 mg/dL

N/V/C (constipation), bone pain, excessive urination, thirst,
confusion, lethargy, slurred speech, cardiac arrest

(1.5-2.5 mEq/L)

Magnesium deficit in ECF; <1.5 mEq/L

NG suctioning, diarrhea, ETOH withdrawal, tube feedings, sepsis, burns

Muscle weakness, tremors, tetany, seizures, mental
status changes, heart block, hyperactive DTR, respiratory paralysis

Magnesium excess in ECF; > 2.5 mEq/L

Renal failure, excessive mag intake (antacids/laxatives)

N/V, weakness, flushing, lethargy, loss of DTR’s,
respiratory depression, coma, cardiac arrest

(2.5-4.5 mg/dL or 1.8-2.6 mEq/L)

P

Mg

Phosphate deficit in ECF; < 2.5 mg/dL OR < 1.8 mEq/L

Alcohol withdrawal, DKA, hyperventilation, diuretics

Irritability, fatigue, weakness, paresthesias, confusion, seizures, coma

Excess phosphate in ECF; >4.5 mg/dL OR >2.6 mEq/L

Impaired kidney excretion, hypoparathyroidism

Tetany, anorexia, nausea, muscle weakness, tachycardia

Cl

(96-106 mEq/L)

Deficit of chloride in ECF; < 96 mEq/L

Severe V/D, drainage of gastric fluid, diuretics, burns

Hyperexcitability of muscles, tetany, hyperactive DTR’s, weakness, muscle cramps

Excess chloride in ECF; >106 mEq/L

Head trauma, increased perspiration

Tachypnea, weakness, lethargy, diminished cognitive
ability, HTN, decreased cardiac output, dysrhythmias, coma