Fluid and electrolyte imbalance

fluid and electrolyte EXCESS patho

heart failure, kidney injury, liver cirrhosis, IV therapy

fluid and electrolyte deficit patho

negative fluid balance and volume depletion, dehydration: N/v, diarrhea, poor PO intake, bleeding

fluid and electrolyte causes excess

renal, cardiac, liver, endocrine disorders, pregnancy, excess IV administration, age >65

fluid and electrolyte causes deficit

fluid losses: GI, burns, excessive sweating or third spacing,

hypernatremia

hypertonic sodium gain, pure water or hypotonic fluid loss, neurologic, cardiac integumentary, Seizures, agitation, low UOP, thirst

hyponatremia

hypovolemic, euvolemic, hypervolemic, neurologic and lab changes, acute: medical emergency, chronic: asymptomatic, seizures, weakness, edema, lethargy, low LOC/confusion

hyperkalemia

shift to extracellular space, metabolic acidosis (DKA), cellular damage: multiple transfusions, rhabdomyolysis, cardiac, neurovascular, musculoskeletal, kidney damage, iatrogenic therapy

hypokalemia

increased aldosterone release, GI losses: N/V, suctioning, poor oral intake, non-potassium sparing diuretics, musckseltal, cardiac, renal, GI

hypermagensimia

cardiac, neurologic dysfunction, affected by sodium, vitamin d, growth hormone, thyroid, parathromone, acute and chornic kidney disease, sleepy/drowsiness, low reflexes, oppressed respirations, weakness, labs: BMP, urinalysis, GFR

magnesium glycinate is for

sleep

magnesium citrate is for

digestion

magnesium oxide

heart

hypomagnesemia

poor PO intake/GI absorption, PPI, calcium phosphates, fats inhibit, cardiac dysrhythmias, kidney disease w/ creatinine clearance <20, labs: BMP, calcium, EKG, Torsad risk, overactive reflexes, restless tremors, seizures, arrhytmias, dtr increases

hypercalcemia

excess parathyroid hormone: malignancy, hyperparathyroidism, excess vitamin d, stone (kidney), tired/lethargy, overactive bone pain, nausea/constipation, EKG

hypocalcemia

decrease parathyroid hormone: injury/removal of parathyroid, hypomagnesemia, alkalosis, pancreatitis, vitamin d, calcitonin, prolonged qt interval, tetany, positive Chvostek and Trousseau sign, Paresthesia, seizures, emotional liability and depression, seizure, positive Chvostek sign, arrhythmia, spasm/tetany, muscle cramps