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50 Cards in this Set
- Front
- Back
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Normal range: Sodium
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135 - 145 mEq/L
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Normal range: Potassium
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3.5 - 5.2 mEq/L
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Normal range: Magnesium
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1.6 - 2.6 mg/dL
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Normal range: Calcium
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8.2 - 10.6 mg/dL
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Normal range: Phosphorus
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2.5 - 4.5 mg/dL
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What is the role of sodium?
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- responsible for stimulation of neuromuscular activity and acid-base balance - regulates renal retention and excretion of water - maintains osmotic pressure of extracellular fluid |
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Hyponatremia
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- loss of sodium or water gain that dilutes extracellular fluid - (Critical Red Flag: < 120) - affects functioning of voluntary and involuntary muscles |
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Causes of hyponatremia
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- nausea, vomiting, and diarrhea - excess diuretic dosage - liver failure - congestive heart failure (heart doesn't pump as well as it should) - increased hypotonic IV fluids |
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Symptoms of hyponatremia
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- anorexia, nausea, cramps - fatigue, lethargy, muscle weakness - headache, confusion, seizures - decreased BP |
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Treatment of hyponatremia
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- intake foods high in sodium - IV Ringer's Lactate or 0.9% NS |
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Hypernatremia
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- above 145 mEq/L - (Critical Red Flag: >160) |
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Causes of hypernatremia
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- dehydration-fluid loss through nausea, vomiting, and diarrhea - diabetes ketoacidosis - fever |
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Symptoms of hypernatremia
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- excessive thirst - dry and sticky tongue/mucosa - weakness, lethargy, agitation - edema - elevated BP |
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Treatment of hypernatremia
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- increase water intake - 5% dextrose in water (hypotonic solution) - diuretics |
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What is the role of potassium?
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- electrical impulses in cardiac and skeletal muscle - most abundant intracellular cation - helps maintain acid-base balance and has inverse relationship to metabolic pH |
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Hypokalemia
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- below 3.5 mEq/L - (Critical Red Flag: < 2.5) |
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Causes of hypokalemia
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- ETOH (alcohol) abuse - Congestive Heart Failure - hypertension - vomiting and diarrhea - respiratory alkalosis - inadequate dietary intake of K+ (rare, but often accompany other causes of K+ depletion) |
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Treatment of hypokalemia
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- foods rich in K+ - balanced electrolyte solutions - sports drinks - IV K+ (administered cautiously to prevent hyperkalemia) |
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Hyperkalemia
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- above 5.0 mEq/L - (Critical Red Flag: >6) |
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Causes of hyperkalemia
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- metabolic acidosis - dehydration - renal failure - tissue damage - burns |
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Symptoms of hyperkalemia
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- dysrhythmias - ECG changes - muscles weakness or paralysis - bradycardia - tingling and numbness - nausea, vomiting, and diarrhea |
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Treatment of hyperkalemia
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- insulin (moves K+ into the cell) - D50 (prevents hypoglycemia caused by the infusion of insulin) - IV Calcium Gluconate also given at the same time to counteract cardiac effects of potassium - Sodium Bicarbonate (treats the acidosis caused when K+ moves into cell and pushes hydrogen ions into the serum) - hemodialysis or peritoneal dialysis - decreased dietary K+ intake |
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What is the role of calcium?
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plays a role in: - coagulation - neuromuscular conduction - intracellular regulation - control of skeletal and cardiac muscle contractility |
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Hypocalcemia
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- below 8.2 mg/dL - (Critical Red Flag: < 7) |
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Causes of hypocalcemia
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- multiple blood transfusions - pancreatitis - removal of parathyroid glands - alcohol abuse - inadequate intake of Vitamin D - loop diuretics |
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Symptoms of hypocalcemia
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- neuromuscular excitability or tetany (severe muscle spasms) - dysrhythmias - hypotension - Chvostek's sign: elicited by tapping on the facial nerve just above the temple. Positive sign is a twitch of the nose or lip - Trousseau sign: contraction of hand or fingers when the arterial blood flow is cut off for 5 mins |
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Treatment of hypocalcemia
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- increased dietary intake - administration of medications |
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Hypercalcemia
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- above 10.6 mg/dL - (Critical Red Flag: >12) |
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Causes of hypercalcemia
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- prolonged immobilization - dehydration - cancer - hyperparathyroidism and excess hormone secretion (increased resorption of calcium from bones) |
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Symptoms of hypercalcemia
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- sedative effect on neuromuscular transmission - kidney stones occur from excess calcium in urine - altered behavior or confusion - critically high levels cause heart block and cardiac arrest |
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Treatment of hypercalcemia
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- eliminate calcium through kidneys through IV fluids (usually 0.9% NS) - loop diuretic - calcitonin |
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What is the role of magnesium?
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required for transmission of nerve impulses and muscle relaxation |
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Hypomagnesemia
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- below 1.6 mg/dL - (Critical Red Flag: < 1.2) |
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Causes of hypomagnesemia
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- malnutrition - chronic alcoholism - renal disease - pancreatitis - metabolic acidosis |
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Symptoms of hypomagnesemia
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increased neuromuscular excitability and tetany (severe muscle spasms)
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Treatment of hypomagnesemia
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- treat underlying cause - medications including magnesium supplements, such as antacids |
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Causes of hypermagnesemia
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- rare, but often caused by renal failure - magnesium-containing antacids (e.g., Gaviscon, Gelusil) |
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Symptoms of hypermagnesemia
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- nausea and vomiting - muscle weakness - hypotension - bradycardia - respiratory depression |
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Treatment of hypermagnesemia
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- removal of magnesium by dialysis - avoidance of magnesium-containing substances |
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Hypermagnesemia
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- above 2.6 mg/dL - (Critical Red Flag: >6.1) |
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Hypophosphatemia
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- less than 2.5 mg/dL
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What is the role of phosphorus?
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- important for energy (ATP) production - metabolism - red blood cell function |
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Causes of hypophosphatemia
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- alcohol abuse - malabsorption syndromes (decreased absorption from GI) - increased excretion by the kidneys - respiratory alkalosis (because of cellular use of phosphate for accelerated glycolysis (ATP) formation) |
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Symptoms of hypophosphatemia
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- conditions related to reduced capacity for oxygen transport by red blood cells and disturbed energy metabolism - when severe: confusion, coma, convulsions, and respiratory failure (due to muscle weakness) |
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Treatment of hypophosphatemia
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- treat underlying condition - oral phosphorus supplements or IV |
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Hyperphosphatemia
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- above 4.5 mg/dL
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Causes of hyperphosphatemia
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- acute or chronic renal failure - phosphate is released into extracellular fluid when cells are damaged or destroyed (e.g., chemotherapy) - long-term laxative abuse |
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Symptoms of hyperphosphatemia
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- symptoms primarily related to low serum calcium levels (caused by high phosphate levels) similar to symptoms of hypocalcemia
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Treatment of hyperphosphatemia
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- dialysis - avoid high phosphorus diet - IV 0.9% NS, aluminum hydroxide, or glucose and insulin to drive phosphate into cells |
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