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This mineral is critical for:
skeletal muscle contraction
carbohydrate metabolism
ATP formation
vitamin activation
cell growth
Magnesium
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This electrolyte is critical for cellular processes. It is a major component of:
the skeleton, providing mineral strength to bone.
This is an integral component of nucleic acids that comprise DNA and RNA. Bonds of this electrolyte are found in ATP! It also functions as a buffer in bone, serum, and urine.
Phosphorus
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Keeping ECF levels high and ICF levels low this electrolyte is vital for skeletal muscle contraction, cardiac conduction, nerve impulse transmission, and normal osmolarity and volume of the ECF.
Sodium (Na+)
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This mineral is important for maintaining bone strength and density, activating enzymes, allowing skeletal and cardiac muscle contraction, controlling nerve impulse transmission and allowing blood clotting.
Calcium (Ca+)
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Keeping the large difference between the concentration of this electrolyte between the ICF and the ECF is critical for excitable tissues to depolarize and to generate action potentials.
Potassium (K+)
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What are the normal ranges of sodium?
135-145 mEq/L
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What are sources of sodium?
- Most food
- prepackaged food
- table salt
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What happens if you overcorrect sodium too fast?
Osmotic demylentation
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Sodium is mainly ECF or ICF?
ECF
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Signs of hyponatremia?
- D-A-N T-H-e B-A-L-D
- dry mucous membranes
- anorexia
- N/V
- tachy
- HA
- BP changes
- ABD cramping
- lethargy
- Diarrhea
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Signs of hypernatremia?
- SALT
- skin flushed
- agitation
- low grade fever
- thirst
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What are common causes of hyponatremia?
- diuretics
- kidney disease
- NPO
- excessive diaphoresis
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What are common causes of hypernatremia?
- kidney failure
- Cushing's syndrome
- hyperaldosteronism
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What are priority interventions for hyponatremia?
- frequent labs and V/S
- if severe - hypertonic solution (0.5-1 mEq/hr)
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What are the priority interventions for hypernatremia?
- Saline locked!
- diuretics
- frequent labs and V/S
- I/O's
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Is potassium mainly ECF or ICF?
98% ICF
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What is the normal ranges of potassium?
3.5-5 mEq/L
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What are sources of potassium?
- bananas
- cantelope
- orange juice
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What are the common causes of hypokalemia?
- diuretics
- digoxin
- corticosteroids
- renal impairment
- D/V
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What are the common causes of hyperkalemia?
- Kidney failure
- Over-ingesting Potassium foods or meds
- potassium sparing diuretics
- ACE inhibitors
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What are S/S of hypokalemia?
- G MODES
- GI changes (hypoactive, N/V, constipation)
- mental status changes
- orthostatic hypotension
- decreased DTR's (deep tendon reflex)
- ECG changes, dysrhythmias
- shallow respirations
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What are S/S of hyperkalemia?
- MURDER
- muscle weakness
- urine, oliguria, anuria
- respiratory distress
- decreased cardiac contractility
- ECG changes
- reflexes, hyperreflexia or areflexia (flaccid)
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What are priority interventions for hypokalemia?
- potassium replacement (10 mEq/100 mL/over 1 hour)
- EKG, cardiac monitoring
- labs
- V/S
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What is the potassium replacement amount?
10 mEq in 100 mL over 1 hour
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What are the priority interventions for hyperkalemia?
- EKG
- K+ restricted diet
- Labs, V/S
- Increasing potassium excretion (Kayexalate)
- Diuretics (Lasix)
- Insulin (put K+ back into cells)
- Albuterol
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What are the normal ranges of calcium?
9-10.5 mg/dL
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Is calcium found mainly in ECF or ICF?
ICF - 99% bones and teeth
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What are sources of calcium?
- Dairy products mainly
- green leafy vegetables
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When looking at calcium levels what must we also look at?
albumin level (3.5-5.5)
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What is the normal albumin level?
3.5-5.5
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What other electrolyte works together with calcium?
- Phosphorus
- ↑Ca+ then ↓Phosphorus
- ↓Ca+ then ↑Phosphorus
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What are the common causes of hypocalcemia?
- Inadequate oral intake
- lactose intolerance
- malabsorption syndromes (Celiac, Crohn's)
- End-stage kidney disease
- diarrhea
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What are the common causes of hypercalcemia?
- excessive intake of calcium
- excessive intake of Vitamin D
- Kidney failure
- thiazide diuretics
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What are the S/S of hypocalcemia?
- CATS
- convulsions
- arrhythmias
- tetany (Trousseau's/Chvostek's)
- spasms and stridor
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What are the S/S of hypercalcemia?
- Bones, Stones, Groans, Moans
- pain in bones, muscle weakness, ↓DTR's
- renal stones
- pain (ABD)
- psychic moans/psychological overtones-confused state
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What are priority interventions for hypocalcemia?
- EKG, monitor cardiac function
- frequent labs, V/S
- Calcium replacement
- Limit stimulation
- Seizure precautions
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What are priority interventions for hypercalcemia?
- Monitor cardiac
- frequent labs, V/S
- Diuretic
- IV fluids (isotonic)
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What function does the parathyroid have on Calcium?
Helps control the absorption of calcium
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What mineral helps control the parathyroid gland?
Magnesium
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What are the normal ranges of phosphorus?
3-4.5 mg/dL
-
Is phosphorus mainly found in the ECF or ICF?
ICF within bone matrix
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What are the sources of phosphorus?
-
What are common causes of hypophosphatemia?
- malnutrition
- starvation
- hyperparathyroidism
- kidney failure
- malignancy
- ETOH
- aluminum or mag based antacids
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What are the common causes of hyperphosphatemia?
- kidney disease
- hypoparathyroidism
- ↑intake of phosphorus
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What are the S/S of hypophosphatemia?
Think HYPERcalcemia
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What are the S/S of hyperphosphatemia?
Think HYPOcalcemia
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What are the priority interventions for hypophosphatemia?
- oral phosphorus
- ↑phosphorus in diet
- small, frequent meals
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What are the priority interventions for hyperphosphatemia?
- diuretics
- increase calcium, phosphate will decrease
- frequent monitoring of V/S, labs
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What are the normal ranges of magnesium?
1.3-2.1 mg/dL
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What are the sources of magnesium?
- beans
- GREEN LEAFY VEGETABLES
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Is magnesium mainly found in the ECF or ICF?
Intracellular
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What are the common causes of hypomagnesemia?
- diarrhea
- malnutrition
- malabsorption syndrome
- ETOH ingestion
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What are the common causes of hypermagnesemia?
- antacids
- milk of magnesium (MOM)
- laxatives
- ↓kidney excretion of mag
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What are the S/S of hypomagnesemia?
- CATS + PAGES
- painful muscle contractions
- anorexia
- GI effects (N, constipation, ABD distension..)
- ECG changes
- skeletal muscle weakness
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What are the S/S of hypermagnesemia?
- WHELS
- weak skeletal muscle contractions/respiratory muscles
- hypotension
- ECG changes
- lethargy
- sweating due to peripheral vasodilation
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What are the priority interventions for hypomagnesemia?
- frequent labs
- IV fluids
- PO or IV magnesium
- monitor cardiac function
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What are the priority interventions for hypermagnesemia?
- diuretics
- D/C magnesium
- dialysis in severe cases
- monitor cardiac function
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