Electrolytes

Hypernatremia

• levels over 145 mEq/L

• causes neurological, endocrine, and cardiac disturbances

• High HR, high BP, thirst, oliguria (low urine output), restlessness, anxiety, edema, dry membranes

• risk factors: water deprivation, heat stroke, excessive sodium intake, excessive sodium retention (kidney failure, cushings), fluid losses (fever, diaphoresis, burns, hyperglycemia)

Hyponatremia

• levels under 136 mEq/L

• High HR, thready pulse, low BP, nausea/vomiting, restlessness, HA, weakness, seizure

Hyperkalemia

• levels over 5 mEq/L

• result of increased potassium levels, movement of potassium out of cells, or inadequate renal excretion

• ECG changes (dysrhymias), ABD cramps, oliguria, muscle cramps, weakness, slow & irregular pulse, hypotension

Hypokalemia

• levels under 3.5 mEq/L

• caused by increased loss of potassium from the body, decreased intake & absorption, or movement of potassium in cells

• ECG changes, low BP, Arrhythmias, nausea/vomiting, decreased peristalsis, polyuria, dizziness, weakness, decreased reflexes, constipation

  • flat T waves, ST depression, prominent U wave

Hypermagnesemia

• levels over 2.1 mEq/L

• Low BP, low HR, weak pulse, dyspnea, low respiratory rate, decreased awareness, confusion, muscle weakness, decreased reflexes

hypomagnesemia

• levels lower than 1.3 mEq/L

• Arrhythmias, high HR, high BP, seizures, delusions, hallucinations, tetany, Chvostek sign (facial twitching) + Trousseau’s sign (hand/wrist spasms, associated with hypocalcemia)

hypercalcemia

• levels higher than 10.5 mEq/L

• Arrhythmias, polyuria, kidney stones, bone pain, decreased reflexes, weakness, lethargy, personality change

hypocalcemia

• levels under 9 mEq/L

• numbness & tingling of extremities, muscle spasms

• arrhythmias, low HR, low BP, weak pulse, paresthesia, muscle spasms,
  seizures, Chvostek sign + Trousseau’s sign, dyspnea, laryngospasm

Hypercholremia

• levels higher than 106 mEq/L

• Irregular HR, high BP, fluid retention, excessive thirst, confusion, personality changes, seizures, fatigue, muscle weakness, spasms, numbness or tingling.

Hypochloremia

• levels lower than 98 mEq/L

• Irregular HR, low BP, fluid loss, diarrhea or vomiting, weakness, fatigue, confusion, muscle cramps, difficulty breathing

Hyperphosphatemia

• levels higher than 4.5 mg/dL

• Arrhythmias, muscle spasms, numbness and tingling around mouth or extremities, seizures, bone and joint pain, itchy skin, rash

Hypophosphatemia

• levels under 3 mg/dL

• Confusion, muscle weakness, fatigue, bone and muscle pain, seizures, numbness, confusion, irritability

hyperbicarbonatemia

• levels over 32 mmol/L

• Confusion, hand tremor, light-headedness, muscle twitching, nausea/vomiting, numbness or tingling in face or extremities, tetany

hypobicarbonatemia

• levels under 22 mmol/L

• High HR, confusion, dizziness, fatigue, loss of appetite, vomiting, HA, rapid breathing or long deep breaths, weakness