Pathophysiology: Electrolytes

Front 1

Sodium

Back 1

Na+
136-145 mEq/L

Front 2

What Sodium does
(8)

Back 2

1. ECF cation
2. A shift in Na triggers a fluid volume change to restore normal solute and water ratios
3. Helps maintain acid-base balance
4. Activates nerve and muscle cells, involved in muscle contraction and the Na+/K+ pump
5. InfluencesH2O distribution with Cl-
6. Regulated by the kidney through tubular reabsorption
7.Aldosterone, a hormone secreted by the adrenal cortex, works to increase the reabsorption of Na+ by the kidney
8. Natriuretic peptides increase Na+ and water excretion

Front 3

Symptoms of Hypo- Sodium
(9)

Back 3

1. Sleepiness
2. Weakness
3. Lethargy
4. N/V or anorexia
5. Behavioral and personality changes
6. Decreased tendon reflexes
7. Headache
8. Seizure
9. Coma

Front 4

Symptoms of Hyper- Sodium
(4)

Back 4

1. Increased thirst
2. Irritability, restlessness, confuseion, agitation
3. Seizures
4. Coma

Front 5

Treatment of Hypo-Sodium
(2)

Back 5

1. Fluid restriction
2. Monitor I/O, VS, Wt., lab values, urine Na+, specific gravity

Front 6

Treatment of Hyper- Sodium
(4)

Back 6

1. Push fluids
2. D5W
3. Inspect for edema
4. Monitor I/O, VS, Wt., lab values, urine Na+, specific gravity

Front 7

Chloride

Back 7

Cl-
98-106 mEq/L

Front 8

What Chloride does
(2)

Back 8

1. Main ECF anion
2. Passive transport, follows Na+

Front 9

Symptoms of Hypo-Chloride
(4)

Back 9

1. Hypoventilation
2. tetany
3. Paresthesia of the extremities
4. Restless, confusion, convulsions

Front 10

Symptoms of Hyper- Chloride
(6)

Back 10

1. Hyperventilation to blow off excess CO2
2. Hypotension
3. Decreased cardiac output
4. Peripheral vasodilation
5. Headache
6. Lethargy

Front 11

Treatment of Hypo-Choloride
(3)

Back 11

1. Increased NaCl in the diet
2. Correct GI symptoms
3. Seizure precautions

Front 12

Treatment of Hyper- Chloride
(3)

Back 12

1. Correct fluid imbalance by giving IV fluids
2. Give sodium bicarb and corrects pH
3. Monitor patient's level of consciousness and respiratory status.

Front 13

Potassium

Back 13

K+
3.5-5 mEq/L

Front 14

What Potassium does
(6)

Back 14

1. Main ICF cation
2. Regulates cell excitability and membrane potential for muscle contraction, cardiac muscle contraction, and nerve impulse contraction.
3. Na+/K+ pump
4. Affects the cell's electrical status
5. ICF osmolality
6. K+ and insulin are required to move glucose into the ICF and for metabolism of Carbohydrates and proteins

Front 15

Symptoms of Hypo-Potassium
(5)

Back 15

1. Muscle weakness and cramps, fatigue, decreased tendon reflexes
2. Postural hypotension
3. Constipation
4. EKG changes and arrhythmias
5. Confusion

Front 16

Symptoms of Hyper-Potassium
(4)

Back 16

1. EKG changes and arrhythmias
2. Nausea, diarrhea, hyperactive bowel sounds with intermittent colic, numbness/tingling of the face, tongue, feet, or hands
3. Fatigue, drowsiness
4. Irritability, mental confusion

Front 17

Treatment of Hypo-Potassium
(2)

Back 17

1. Replace K+ orally or by IV
2. Monitor I/O, heart monitor, labs, mental status

Front 18

Treatment of Hyper-Potassium
(5)

Back 18

1. Kayxelate
2. Insulin, bicarb, and dextrose fluids
3. Dialysis
4. Goal: increase excretion and move the potassium into the cells
5. Monitor I/O, heart monitor, labs, mental status

Front 19

Total Calcium

Back 19

Ca++
9-10.5 mg/dl

Front 20

Ionized (free) serum Calcium

Back 20

Ca++
4.5-5.6 mg/dl

Front 21

What Calcium does
(4)

Back 21

1. Found in equal amounts in ECF and ICF
2. Major cation for bones and teeth, important for their development and maintenance
3. Found in cell membranes and maintains their shape, and is required for muscle contraction, necessary for the synaptic release of neurotransmitters for transition of nerve impulses, cardiac and skeletal muscle contractions are initiated by release of calcium, Ca++/Na+/K+/Mg++ help to maintain muscle tone
4. Aids in coagulation

Front 22

Symptoms of Hypo-Calcium
(8)

Back 22

1. Confusion, convulsions, insomnia
2. Parashesias around the mouth and hands
3. Carpopedal spasm, tetany
4. Hyperreflexia
5. Brittle nails, osteoporosis, periodontaldisease
6. Diarrhea
7. Positive Chvostek and Trousseau signs
8. Cardiac arrhythmias

Front 23

Symptoms of Hyper-Calcium
(7)

Back 23

1. N/V
2. Constipation
3. Confusion, weakness, lethargy
4. Polydipsia, polyuria, dehydration
5. Decreased deep tendon reflexes
6. Bone pain
7. Cardiac arrhythmias or arrest

Front 24

Treatment of Hypo-Calcium
(6)

Back 24

1. D/C meds known to lower Ca++
2. Administer Ca++
3. Treat low Mg++ level
4. Treat causes
5. Monitor heart
6. Calcitriol/ Vit. D

Front 25

Treatments of Hyper-Calcium
(8)

Back 25

1. D/C Ca++ meds
2. Treat causes
3. IV NS with Lasiz
4. Phosphates
5. Calcitonin
6. Meds for bone pain, N/V
7. Laxitives
8. Heart Monitor

Front 26

Phosphate Serum Phosphorus

Back 26

3-4.5 mg/dl

Front 27

What Phosphate Serum Phosphorus does
(1)

Back 27

Phosphorous and calcium are generally opposite, high phosphorus = low Ca++

Front 28

Symptoms of Hypo-Phosphate Serum Phosphorus
(4)

Back 28

1. Causes reduced oxygen transport by RBCs, hypoxia can occur, also bradycardia
2. Dysfunctions in WBCs and platelets causing increased risk of infection and bleeding
3. Affects nerve and muscle function
4. Bone resorption occurs, which may lead to rickets or osteomalacia

Front 29

Symptoms of Hyper-Phosphate Serum Phosphorus

Back 29

Symptoms are generally those of hypocalcemia

Front 30

Treatment of Hypo-Phosphate Serum Phosphorus
(2)

Back 30

1. Treat underlying cause
2. A low phosphorous level is generally not life threatening, but administration of phosphate salts can be.

Front 31

Treatment of Hyper-Phosphate Serum Phosphorus
(3)

Back 31

1. Correct underlying cause
2. Dialysis, if renal failure is present
3. Give Aluminum hydroxide-binds to phosphate in the GI tract and eliminates it.

Front 32

Magnesium

Back 32

Mg++
1.3-2.1 mEq/L

Front 33

What Magnesium does
(5)

Back 33

1. A major ICF cation
2. 40-60% of the body's magnesium is stored in the bone, with the remainder in the soft tissues and muscle cells
3. Aids in protein synthesis, necessary for the formation and function of healthy bones
4. Important in nerve impulse transmission
5. Regulated by the kidney, and low levels cause the kidneys to conserve

Front 34

Symptoms of Hypo-Magnesium
(7)

Back 34

1. Neuromuscular irritability, twitching, nystagmus, tremors, cramping, tetany
2. Disorientation
3. Depression
4. Hyperreflexia
5. Swallowing difficulties, N/V
6. Positive Chvostek's and Trousseau signs
7. Monitor for cardiac arrhythmias

Front 35

Symptoms of Hyper-Magnesium
(6)

Back 35

1. Increased perspiration
2. Muscle weakness, decreased deep tendon reflexes
3. Nausea, vomiting
4. Hypotension
5. Cardiac arrhythmias
6. Respiratory compromise

Front 36

Treatment of Hypo-Magnesium
(1)

Back 36

Give PO or IV Mg++

Front 37

Treatment of Hyper-Magnesium
(2)

Back 37

1. Monitor cardiac and respiratory status, I/O, neruo status, labs
2. Give IV fluids, diuretics, calcium gluconate