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Major cations within the cell?
Potassium, Magnesium
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Major anion within cell?
Phosphorous
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Major cations outside the cell?
Sodium, Calcium
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Major anion outside the cell?
Chloride, Bicarbonate
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Normal range of Na+
135-145mEq/mL
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Symptoms of Hyponatremia?
Confusion, N/V, Seizures**, Coma, Decreased BP**, Tachycardia**, Increased Intracranial Pressure**
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Causes of Hyponatremia?
Diuretics, Vomiting, Diarrhea, Excessive water intake, excessive D5W
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Treatments for Hyponatremia?
Hypertonic IV sol'ns (LR/0.9% NaCL), Fluid restriction, Na+ rich foods
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What are some of the early sx of Hypernatremia
Polyuria, Anorexia, Thirst, Dry Mucous Membranes, Hypotension, Tachycardia
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What are some of the late sx of Hypernatremia?
Confusion, seizures, coma, tremors, muscle twitching, rigid paralysis
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What are some of the causes of Hypernatremia?
Excess fluid loss or sodium intake, Hypertonic tube feedings, Diarrhea, Hyperventilation, Diabetes insipidus, Lg amounts of salt water,
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Treatment of Hypernatremia?
Hypotonic IV (0.3% or 0.45% NaCl; 5%D5W); Diuretics, Decrease sodium intake, Increase oral fluids
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Normal range of Potassium K+?
3.5-5.5 mEq/L
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Symptoms of Hypokalemia?
Shallow respirations, Irritability, Confusion, Weakness, Arrhythmias, Lethargy, Thready Pulse, Decreased intestinal motility
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Causes of Hypokalemia?
Abnormal loss through GI tract or Kidneys (diuretic use), Mg+ deficiency, Metabolic alkalosis
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Treatment of Hypokalemia?
Oral K+ supp, Increase dietary intake, IV (max.20mEq/L/hr!!!)
NEVER EVER IV PUSH!!!!!!
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Causes of Hyperkalemia?
Massive intake of K+, Impaired renal excretion, Shift from ICF to ECF, Digitalis use; Secondary to cell destruction
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Sx of Hyperkalemia?
Weak/Paralyzed skeletal muscles, Hypotension, V-fib (EKG changes-Tall T Waves/dysrhythmias), Abd cramping/diarrhea
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Treatment of Hyperkalemia?
Diuretics, Dialysis, Kayexalate-(eliminate K+), Insulin and glucose (force K+ into ICF), IV Bicarb
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Normal range of Calcium?
4.5-5.5 mEq/L or 9-11mg/dl
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Causes of Hypocalcemia?
Decreased production of PTH, Acute pancreatitis***; Multiple blood transfusions, Alkalosis, Decreased intake, Steroid use
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Sx of Hypocalcemia?
Muscle tetany (+Trousseau's or Chvostek's sign), Dysphagia, Spontaneous fx's, Tingling around mouth or in extremities
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Treatment for Hypocalcemia?
Oral or IV Ca+ supp; Treat pain and anxiety to prevent hyperventilation-induced resp. alkalosis
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Causes of Hypercalcemia?
Hyperparathyroidism, Malignancy, Vit D overdose, Prolonged immobilization, Thiazide diuretic use (reduces Ca+ secretion)
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Sx of Hypercalcemia?
Decreased memory, confusion, disorientation; fatigue, weakness, absent/depressed reflexes; constipation; dysrhythmias
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Normal range of Phosphorous/Phosphate?
1.7-2.6 mEq/L or 2.5-4.5mg/dl
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Causes of Hypophosphatemia?
Malnourishment/malabsorption, alcohol withdrawal, use of phosphate-binding antacids, inadequate replacement during parenteral nutrition
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Sx of Hypophosphatemia?
CNS depression, confusion, muscle weakness, dysrhythmias, cardiomyopathy
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Treatment of Hypophosphatemia?
Oral supp, ingestion of high phophorous foods, IV Na+ or K+ phophate (10mEq/hr)
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Causes of Hyperphosphatemia?
Acute or chronic renal failure, chemotherapy, excessive ingestion of phosphate or Vit D
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Sx of Hyperphosphatemia?
Early signs: Tachycardia, palpitations
Late signs: Tetany, hyperflexia
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Treatment of Hyperphosphatemia?
Restrict foods and fluid with Phophate, adequate hydration and correction of hypocalcemic conditions, monitor urine output, avoid carbonated beverages
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Which two electrolytes have an inverse relationship due competition for binding with similar pharmalogical structures?
Calcium & Phosphorous
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What is the normal range for Magnesium?
1.5-2.5 mEq/L or 1.8-3.0 mg/dl
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Causes of Hypomagnesemia?
Prolonged fasting or starvation, Chronic alcoholism, GI fluid loss, Prolonged parenteral nutrition without supp, Diuretics
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Sx of Hypomagnesemia?
Confusion, Hyperactive deep tendon reflexes, Tremors, Seizures, Dysrhythmias
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Treatment for Hypomagnesemia?
Oral supps, Increase dietary intake, Parenteral IV or IM Mg+ when severe
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Causes of Hypermagnesemia?
Increased intake or ingestion with renal insufficiency or failure
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Sx of Hypermagnesemia?
Lethargy/drowsiness, N/V, Loss of deep tendon reflexes, Resp. and Cardiac arrest
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Treatment of Hypermagnesemia?
Increase fluid intake, (for emergent) IV Ca+ Chloride or Ca+Gluconate, Dialysis
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