Treatments for Electrolyte Imbalances

Hypernatremia (Na >145)

D5W, Fluids, Drink water, Flush NGT with water

Hyponatremia (Na <135)

Treat the cause, 0.9% NS, 3% NS given in slow rate (closely monitor pt). Salt tablets, regular diet, increase salt in food, restrict fluid.

Hyperkalemia (K >5)

Kayexalate (PO), IV Regular Insulin and D50.

Hypokalemia (K <3.5)

Potassium Supplements PO e.g. Potassium Chloride, K Rider IV (10 mEq/hr infusion), eat food high in K.

Hypermagnesemia (Mg > 2.6)

Fluids w/o magnesium, Stop magnesium supplement.

Hypomagnesemia (Mg <1.8)

Magnesium Oxide PO, Magnesium Sulfate IV (1gram/hr infusion).

Hypercalcemia (corrected Calcium >10.5)

Avoid factors (thiazide, lithium carbonate, prolonged bed rest, high calcium diet, Vitamin D, multivitamins with calcium), calcitonin IM/Subcutaneously, Biphosphonates (e.g. Pamidronate, Ibandronate).

Hypocalcemia (corrected calcium <9)

Oral calcium supplements/multivitamins with calcium, Vitamin D, IV Calcium Gluconate.

Hyperphosphatemia (Phos >4.5)

(if renal failure is the cause) then dialysis, limit phosphate intake, take phosphate binders e.g. Renagel, Sevelamer, Phoslo (take with food).

Hypophosphatemia (Phos <3)

Phosphorus supplement: Phos-nak PO, IV Phosphorus (e.g. Potassium Phosphate, Sodium Phosphate).