lab values: electrolytes, minerals, and elements

Sodium range

135 to145mEq/L

Hyponatremia

• Altered mental status

• Agitation

• Anorexia

• Apathy

• Headache

• Muscle Cramps

• Vomiting

• Nausea

Hypernatremia

-Elevated thirst
-Confusion
-Muscle twitching
-Seizures
-Coma

Potassium range

3.8 to 5.0 mEq/L

Hypokalemia

-        Hypotension

-        Areflexia

-        Cramps

-        Loss of smooth muscle function

-        Weakness

-Nephropathy

Hyperkalemia

-        Cardiac rhythm disturbances

-        Bradycardia

-        Hypotension

-        Cardiac arrest

-Muscle weakness

Chloride range

95-103 mEq/L

Hypochloremia

• vomiting

• gastric outlet obstruction

• metabolic ketoacidosis

hyperchloremia

• metabolic acidosis

• interstitial renal disease

• GI bicarbonate loss from diarrhea

• acetazolamide-induced carbonic anhydrase inhibition

Magnesium range

1.7-2.4 mg/dL

Hypomagnesemia

• symptoms similiar to hypocalcemia

• proloned QT interval

• increased risk of arrythmias

• EKG abnormalities

Hypermagnesemia

• muscle weakness

• decrease in deep tendon reflexes

• fatigue

• lethargy

• mental confusion

• hypotension

• coma

• paralysis

• cardiac arrest

calcium range

9.2-11 mg/dL

hypocalcemia

-        hyperparathyroidism

-        increase bone resorption

-        bones lose their structural integrity

-        susceptible to fracture

-        tetany

-        EKG changes and arrythmias

-        Fatigue

-        Depression

-        Memory loss

-        Hallucinations

-        Seizures

-        Finger numbness

-        Tingling and burning of extremities

-        Paresthesia

• Mental instability and confusion

hypercalcemia

• vague GI complaints

• nausea

• vomiting

• abdominal pain

• dyspepsia

• anorexia

• peptic ulcer disease

• lethargy, obtundatiom, psychosis, coma, and death

• EKG and ventricular arrythmias

• renal failure in extreme cases

phosphate range

2.3- 4.7 mg/dL

hypophosphatemia

• neurologic irritability

• muscle weakness

• rhabdomyolysis

• hemolysis

• platelet dysfunction

• cardiac and respiratory failure

• encephalopathy

• confusion

• seizures

• coma

hyperphophatemia

• renal function may diminish

copper range

70 - 140 mcg/dL for men

80 - 155 mcg/dL for women

hypocupremia

• ataxia

• numbness

• peripheral neuropathy

• psycosis

• abnormal glucose tolerance

• arrythmias

• hypercholesterolemia

• athersclerosis

• depressed immune function

• defective connective tissue formation

• demineralization of bones

• pathologic fractures

• Menkes syndromes

• Wilson disease

hypercupremia

• nausea

• vomiting

• intestinal cramps

• diarrhea

• shock

• hepatic necrosis

• intravascular

• hemolysis

• renal impairment

• coma

• death

Zinc range

50 - 150 mcg/dL

Hypozincemia

• severe dermatitis

• chronic diarrhea

• emotional disturbances

• growth retardation

• dysgeusia

• hyposmia

• Pica

• alopecia

• skin lesions

• paronychia

• nail deformity

• photophobia

• blepharitis

• conjunctivitis

hyperzincemia

• drowsiness

• lethargy

• increased serum lipase

• increased amylase concentration

• nausea

• vomiting

• diarrhea

selenium range

150 - 240 ng/mL

Selenium deficiency

• may increase the risk of advanced prostate cancer and skin cancer in men

selenium excess

• garlic breath odor

• metallic taste in the mouth

• hair and nail loss

• GI and neurologic symptoms

• acute respiratory distress syndrome

• tremors

• kidney failure

• cardiac death

manganese range

4 - 15 mcg/L

Manganese deficiency

• bone demineralization

• poor growth in children

• skin rashes

• hair depigmentation

• decreased serum lipids

• depression

• increased premenstrual pain in women

Manganese excess

• encephalopathy

• profound neurologic disturbances (mimic parkinsons)

• anorexia

• apathy

• headache

• erectile dysfunction

• speech disturbances

• manganese pneumonitis

Chromium range

0.3 - 0.9 ng/mL

Chromium deficiency

• insulin resistance and impaired glucose metabolism

• hypercholesterolemia

• increased risk for developing atherosclerotic disease

Chromium excess

• no documented side effects

Sodium function

-Maintain electric potential for action potential and neuromuscular functioning

-Regulate serum osmolality (estimate of water-solute ratio in vascular fluid; useful for evaluating intravascular volume)

-Regulate water balance

Potassium function

• Regulation of muscle and nerve excitability

• Plays an important role in the control of intracellular volume

• Involved in protein synthesis, enzymatic reactions, and carbohydrate metabolism

• Effects action potential (especially on muscle and nervous tissue excitability)

Chloride function

• Balances out positive charges in the extracellular fluid

• Helps maintain extracellular osmolality

Magnesium function

• Maintaining neuromuscular functions and enzymatic functions

• Cofactor for phosphorylation of ATPs from adenosine phosphates

• Vital for binding macromolecules to organelles

Calcium function

-        important for propagation of neuromuscular activity

-        regulation of endocrine functions

-        blood coagulation and platelet aggregation

-        bone and tooth metabolism

Phosphate function

• Important in intracellular metabolism of proteins, lipids, and carbohydrates

• Major component in phospholipid membranes, ribonucleic acids, cyclic adenine, and guanine nucleotides

• Important for the formation of high-energy bonds for the production of ATP

• Regulates the release of oxygen from Hgb to tissues

Copper function

-        Synthesis and functions of many circulating proteins and enzymes

-        Factor for the formation of connective tissues (collagen and elastin)

-        Regulates the cellular uptake and physiologic formation or maintenance of myelin and other phospholipids

-        Metabolism of catecholamines

-        Affects the function of tyrosinase in melanin synthesis albinism

-        Thermal regulation

-        Glucose metabolism

-        Blood clotting

Zinc function

• Tissue growth and repair

• Cell membrane and stabilization

• Bone collagenase activity and collagen turnover

• Immune response (especially T-cell mediated response)

• Sensory control of food intake

• Spermatogenesis and gonadal maturation

• Normal testicular function

selenium function

• Antioxidant

• Help protect cells from oxidative damage

Manganese function

• Cofactor for numerous diverse enzymes involved in carbohydrate, protein, and lipid metabolism

• Protection of cells from free radicals

• Steroid biosynthesis

• Metabolism of biogenic amines

Chromium function

• Cofactor for insulin

• Important for glucose tolerance, glycogen synthesis, amino acid transport, and protein synthesis

• Involved in the activation of several enzymes