Electrolytes

try not to kys

Na+ normal value

136-145 mEq/L

K+ normal value

3.5-5 mEq/L

Ca+ normal value

9-10.5 mg/dL

Mg+ normal value

1.3-2.1 mEq/L

P- normal value

3-4.5 mg/dL

Hyponatremia causes

deficient sodium, excessive water intake

what can cause a patient to have deficient sodium?

vomiting/diarrhea, hypoaldosteronism, diet restrictions

what can cause a patient to have excessive water?

hyperglycemia, overconsumption of water, FVE (renal failure, HF, SIADH)

neuromuscular manifestations of hyponatremia

headache, confusion, muscle WEAKNESS, seizures

GI manifestations of hyponatremia

nausea, vomitting, diarrhea

other manifestations of hyponatremia?

hypovolemia (sodium follows water) and hypervolemia (excess fluid dilutes salt)

thirst, dry mucous membranes, hypotension, decreased u/o

hypertension, edema, weight gain, increased u/o

causes of hypernatremia

excessive sodium, deficient water

what can cause a patient to have excess sodium?

increased salt in the diet, Cushing’s syndrome, hyperaldosteronism

what can cause a patient to have deficient water?

vomitting, diarrhea, diabetes insipidus (lack of ADH), diuretic use, loss of thirst/inability to drink water

neuromuscular manifestations of hypernatremia

headache, confusion, muscle CRAMPS, seizures

other manifestation of hypernatremia?

hypovolemia

thirst, dry mucous membranes, decreased urine output, hypotension, tachycardia

causes of hypokalemia

excess loss of potassium, deficient potassium intake, alkalosis, excess insulin

what causes excessive potassium loss?

vomitting, diarrhea, NGT suctioning, laxatives

Kidneys: losing diuretics, cushings syndrome

causes of deficient potassium intake

malnutrition, extreme dieting, ALCOHOLISM

cardiac manifestations of hypokalemia

flattened T waves, presence of U-wave, weak and irregular pulse

GI manifestations of hypokalemia

decreased GI motility = nausea/constipation, hypoactive bowel sounds, abdominal distention

neuromuscular manifestations of hypokalemia

paresthesia, muscle weakness, muscle cramps, confusion

causes of hyperkalemia

deficient potassium excretion, excess potassium intake, trauma, heart attack, DKA, acidosis

what can cause deficient potassium excretion

renal failure, ACE inhibitors, K-sparing diuretics

what can cause excess potassium intake?

increased potassium intake either by mouth (PO) or IV

cardiac manifestations of hyperkalemia

tall peaked T waves, bradycardia

GI manifestations of hyperkalemia

increased GI motility, nausea and diarrhea

neuromuscular manifestations of hyperkalemia

paresthesia, flaccid paralysis, muscle weakness, muscle cramps, anxiety

causes of hypocalcemia

deficient calcium intake/release from bone, excess calcium losses

causes of deficient calcium intake

renal failure (chronic kidney disease), alcoholism, absorption disorders

causes of excess calcium intake

hypoparathyroidism, renal failure, diarrhea, laxatives

manifestations of hypocalcemia

trousseau’s/chvostek’s sign, diarrhea, decreased bone density, increased deep tendon reflexes, prolonged QT interval

causes of hypercalcemia

excess calcium intake/release from bone, deficient calcium excretion

what causes excessive calcium intake

immobility, calcium antacids/supplements, vitamin D deficiency (helps calcium into the bone)

what causes deficient calcium excretion?

renal failure, hyperparathyroidism

manifestations of hypercalcemia

muscle weakness, nausea, vomitting, constipation, polyuria, renal calculi, decreased deep tendon reflexes, short QT interval

causes of hypomagnesemia

deficient magnesium intake, excess magnesium excretion

what causes deficient magnesium intake

alcoholism, malnutrition, preeclampsia (pregnant women)

what causes excess magnesium excretion

diuretics and diarrhea

manifestations of hypomagnesemia

diarrhea, decreased bone density, increased deep tendon reflexes, prolonged QT interval

same manifestations as hypocalcemia, minus the signs

causes of hypermagnesemia

excess magnesium intake, deficient magnesium excretion

what causes excess magnesium intake

excessive antacid use (contain Mg)

what causes deficient magnesium excretion

renal failure (CKD), excess laxative use (contain Mg)

manifestations of hypermagnesemia

muscle weakness, nausea, vomitting, constipation, polyuria, renal calculi, decreased deep tendon reflexes, short QT interval

same as hypercalcemia

causes of hypophosphatemia

excess calcium intake/release from bone, deficient calcium excretion

same as causes of hypercalcemia

manifestations of hypophosphatemia

muscle weakness, nausea, vomitting, constipation, polyuria, renal calculi, decreased deep tendon reflexes, short QT interval

same as hypercalcemia

causes of hyperphosphatemia

deficient calcium intake/release from bone, excess calcium losses

same as hypocalcemia

manifestations of hyperphosphatemia

trousseau’s/chvostek’s sign, diarrhea, decreased bone density, increased deep tendon reflexes, prolonged QT interval

same as hypocalcemia