Electrolytes n Acid-Base!

135-145 mEq/L

normal range for sodium

3.5-5.0mEq/L

normal range for potassium

8.5-10 mg/dL

normal range for calcium

1.3-2.1 mEq/L

normal range for magnesium

98-106 mEq/L

normal range for Chloride

2.5-4.5 mg/dL

normal range for phosphate

Essential to bone and teeth formation. Required for muscle contraction, nerve transmission, and blood clotting. Regulates cell membrane permeability.

Functions of calcium

Component of bones and teeth. Involved in energy transfer in cells (ATP). Nerve and muscle function

Functions of phosphate

plays a role with acid-base balance in the body along with balancing the fluids in our body by working with sodium to maintain osmotic pressure. needed to make stomach acid.

Function of chloride

Major cation in extracellular fluid. Regulates fluid balance and blood pressure. required for nerve impulse transmission and muscle contraction

Function of sodium

muscle and nerve function (helps muscles contract and relax), heart rhythm support, enzyme reactions (energy production ATP)

Function of magnesium

Nerve impulse conduction and muscle contraction, fluid balance, major intracellular cation

Function of potassium

7.35-7.45

Normal body pH

35-45 mmHG

normal CO2 levels

22-26 mEq/L

normal HCO3 levels (bicarb)

Respiratory Acidosis

Arises from hypoventilation and lungs are unable to excrete enough CO2

Respiratory Alkalosis

Arises from hyperventilation and too much CO2 is excreted

Metabolic Acidosis

Occurs when the body makes too much acid or loses too much bicarb

Metabolic Alkalosis

Occurs when the body looses too much acid or has too much HCO3

Respiratory Acidosis

Arterial blood gas alterations: pH below 7.35, PaCO2 above 45 mm Hg (6 kPa), HCO3− level normal if uncompensated or above 28 mEq/L (28 mmol/L) if compensated. Based on these lab findings, what’s going on

Impaired Gas Exchange COPD, bacterial pneumonia, airway obstruction, extensive atelectasis (collapsed alveoli), severe acute asthma episode Impaired Neuromuscular Function Respiratory muscle weakness or paralysis, resp. failure, chest wall injury Dysfunction of Brainstem Respiratory Control Drug overdose w a resp. depressant, some head injury

Causes of respirator Acidosis

Respiratory Alkalosis

Arterial blood gas alterations: pH above 7.45, PaCO2 below 35 mm Hg (4.7 kPa), HCO3− level normal if short lived or uncompensated or below 21 mEq/L (21 mmol/L) if compensated. Based on these lab findings, what’s goin on?

Hypoxemia, acute pain, anxiety, psychological distress (sobbing), wrong ventilator settings, stimulation of brainstem resp. control

Respiratory Alkalosis Causes

Metabolic Acidosis

Arterial blood gas alterations: pH below 7.35, PaCO2 normal if uncompensated or below 35 mm Hg (4.7 kPa) if compensated, HCO3− level below 21 mEq/L (21 mmol/L). Based on these lab findings, what’s going on

Increase of Metabolic Acids Ketoacidosis, hypermetabolic states (severe hypothyroidism, burns, infection), Oliguric renal disease, circulatory shock (lactic acidosis), ingestion of acid / acid precursors Loss of Bicarbonate Diarrhea, pancreatic fistula, intestinal decompression, renal tubular acidosis

Causes of Metabolic Acidosis

metabolic alkalosis

Arterial blood gas alterations: pH above 7.45, PaCO2 normal if uncompensated or above 45 mm Hg (6.0 kPa) if compensated, HCO3− above 28 mEq/L (28 mmol/L) these lab findings indicate what

Increase of Bicarbonate excessive administration of sodium bicarbonate, massive blood transfusion, mild or mod. ECV deficit Loss of Metabolic Acid Vomiting, gastric suctioning, hypokalemia, excess aldosterone

Causes of metabolic alkalosis

hypokalemia

A patient with severe vomiting for three days presents with muscle cramps, fatigue, and an irregular heartbeat. Which electrolyte imbalance is most likely?

metabolic alkalosis

A patient with prolonged nasogastric suction is at risk for which acid-base imbalance?

magnesium

Which electrolyte plays a key role in neuromuscular function and is closely linked to calcium and potassium balance?

D

A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. What is the priority intervention?

A) Administer potassium chloride IV
B) Give sodium polystyrene sulfonate (Kayexalate)
C) Encourage a high-potassium diet
D) Administer IV calcium gluconate

B

Which electrolyte imbalance is most commonly associated with Chvostek’s and Trousseau’s signs?

A) Hypernatremia
B) Hypocalcemia
C) Hyperkalemia
D) Hypophosphatemia

b

(In metabolic acidosis, the body tries to compensate by increasing respiratory rate and depth to "blow off" CO₂ (acidic gas). Kussmaul respirations are a classic sign of metabolic acidosis, especially in diabetic ketoacidosis (DKA) and renal failure.)

A patient with metabolic acidosis is likely to have which respiratory pattern?
A) Slow, shallow respirations
B) Deep, rapid respirations
C) Irregular, gasping breaths
D) Normal respiratory rate and depth

“Low and slow” symptoms: confusion, lethargy, headache, seizures, muscle weakness, and in severe cases, coma.

Common symptoms of hyponatremia (<135 mEq/L)

“Big and Bloated” symptoms: excess thirst, dry mucous membranes, confusion, irritability, decreased level of consciousness, seizures if severe.

Common symptoms of hypernatremia (> 145 mEq/L)

“Low and slow”: muscle weakness, leg cramps, decreased reflexes, flattened T waves, dysrhythmias, hypotension

symptoms of hypokalemia (<3.5 mEq/L)

Tight and contracted: Peaked T waves, muscle twitching, arrhythmias, severe cases = cardiac arrest

Symptoms of hyperkalemia (> 5 mEq / L)

CATS : Chvostek’s sign, Arrhythmias, Trousseau’s sign, Spasms. Increased neuromuscular excitability: muscle cramps, twitching, hyperactive reflexes

Common signs of hypocalcemia (<8.5 mg/dL)

“Bones, Stones, Groans n Moans” (Bone fractures, kidney stones, groans aka constipation, moans aka mental confusion), decreased neuromuscular excitability

Signs of hypercalcemia (>10 mg/dL)

Increased neuromuscular excitability, hyperreflexia, tremors, seizures, cardiac dysrhythmias (Torsades de Pointes)

Common signs of hypomagnesemia (<1.5 mg / dL)

Decreased neuromuscular excitability, hyporeflexia, bradycardia, respiratory depression

Signs of hypermagnesemia (>2.5 mg/dL)

Weakness, respiratory failure, confusion, decreased energy (low ATP)

Symptoms of hypophosphatemia (<2.5 mg/dL)

Muscle cramps, tetany, symptoms similar to hypocalcemia

Signs of hyperphosphatemia (>4.5 mg/dL)

phosphorus

Calcium has an inverse relationship with ____. When calcium goes up, this goes down.

potassium

Sodium has an inverse relationship with _____. When sodium goes up, this goes down and vice versa

phosphorus

Magnesium has an inverse relationship with ____. when magnesium goes up, this goes down

Chloride

Sodium and ____ have a direct relationship. When sodium goes up, this does too and vice versa

Stops you from peeing - reabsorbs water in the kidneys, increases BP, decreases urine output. Secreted when dehydrated or BP is too low.

Function of Antidiuretic Hormone ADH

Holds onto salt and water, Reabsorbs sodium and water, excretes potassium. increases Blood volume and BP

Function of Aldosterone

Sudden weight loss, skin tenting, dry mucous membranes, weak thready pulse, lightheadedness, hypotension, tachycardia, oliguria (low urine output and dark urine), dizziness/confusion/lethargy

Symptoms of ECV deficit (hypovolemia)

Edema (Esp. in hands, feet, legs), rapid weight gain, hypertension, bounding pulse, JVD, pulmonary edema, polyuria

Symptoms of hypervolemia (ecv excess)