ELECTROYLES SIMPLIFY

What is the normal range of sodium (Na⁺) in the body?

135-145 mEq/L

What is the goal of sodium (Na⁺) in the body?

Maintain blood pressure and blood volume via Aldosterone and RAAS.

What are the signs and symptoms of hypernatremia (6)

Dry mouth/thirst, dry skin, increased fluid retention (edema), decreased urine output, agitation/restlessness/confusion, flushed skin/fever.

What are the signs and symptoms of hyponatremia (9)

Headache, confusion, seizures, trouble concentrating, abdominal cramping, decreased DTRs, loss of urine and appetite, shallow respirations.

What is the normal range of potassium (K⁺) in the body?

3.5-5.0 mmol/L

What is the goal of potassium (K⁺) in the body?

Heart and muscle contraction, making strong heart contractions.

What are the signs and symptoms of hyperkalemia? (7)

Irregular heartbeat (ST elevation, peak T wave) , decreased BP/HR, respiratory failure, hyperactive bowel sounds (diarrhea), confusion, cramping.

What are the signs and symptoms of hypokalemia? (8)

Irregular/thready pulse (ST depression, prominent U wave), decreased BP/HR, decreased bowel sounds, flaccid paralysis, weakness, tingling, peeing a lot, confusion.

What is the normal range of calcium (Ca²⁺) in the body?

9-11 mg/dL

What is the goal of calcium (Ca²⁺) in the body?

Build strong bones, strong heartbeats, and support clotting factors.

What are the signs and symptoms of hypercalcemia? (9)

Decreased HR, BP, RR, muscle weakness, constipation, nausea/vomiting/ ALOC, decreased muscle excitability, bone pain. short QT/ wide T wave

What are the signs and symptoms of hypocalcemia? (6)

Trousseau's sign (arm spasm with BP cuff), Chvostek's sign (facial twitch when tapping), diarrhea, vomiting, seizures, cardiac abnormalities (ventricular tachycardia, prolonged QT/ST).

What is the normal range magnesium (Mg²⁺) in the body?

1.5-2.5 mEq/L

What is the goal of magnesium (Mg²⁺) in the body?

Muscle relaxation.

What are the signs and symptoms of hypomagnesemia? (6)

Neuromuscular irritability, tremors, increased DTRs, tachycardia, confusion, seizures.

What are the signs and symptoms of hypermagnesemia? (5)

Muscle weakness, vasodilation (hypotension), decreased DTRs, respiratory arrest, cardiac arrest.

What is the normal range of phosphate (PO₄³⁻) in the body?

2.5-4.5 mg/dL

What is the goal of phosphate (PO₄³⁻) in the body?

Builds strong bones, teeth, and muscles.

What are the signs and symptoms of hyperphosphatemia? (5)

Same as hypocalcemia – muscle cramps, Trousseau’s sign, Chvostek’s sign, diarrhea, weak bones.

What are the signs and symptoms of hypophosphatemia? (9)

Brittle, weak bones, osteomalacia, fractures, decreased cardiac output, immunosuppression, irritability, seizure, confusion.

what causes hyperkalemia? (8)

Ace inhibitors, NSAIDS, renal impairment (kidney disease or dialysis), burns or trauma (potassium goes out of the cell), spironolactone

what type of ACE inhibitors cause hyperkalemia? (3)

renal impairment (kidney disease or dialysis)

IV fluids

Addisson (aldosterone that regulates potassium)

what can we do to help hyperkalemia? (6)

IV sodium bicarbonate, IV calcium gluconate (calms the muscles), albuterol, furosemide hydrochlorothiazide, dialysis (watch EKG) and sodium polycystrene sulfonate

what type of diet do we need to put someone with hyperkalemia on?

no salt substitutes, no fruit, and no green leafy vegetables

what causes hypokalemia (8)

dehydration, diuretics (furosemide), diarrhea/vomiting, drains (NG tubes), severe acid base imbalance, hyperaldosteronism, corticosteroids (water retention), insulin albuterol (pushes potassium in the cell)

what can we do to help hypokalemia (8)

look at EKG, respirations, GI, I/O, BUN, creatine, glucose, and oral supplements with food

why do we need to watch magnesium levels in hypokalemia?

Potassium and magnesium are best friends

why do we need to look at Calcium and sodium in hypokalemia?

they are inversely related

why are we holding potassium wasting diuretics in hypokalemia?

because low potassium causes digoxin toxicity

if hypokalemia is less than 2.5 what can we do and what must we look for/ follow when giving it?

give potassium infusion. we must push it slowly and look for infiltration

what are 5 potassium sparring diuretics?

spironolactone, Aldactone, dyazide, triamterene, maxide

what 11 foods contain potassium?

potatoes, pork, oranges, tomatoes, avocadoes, strawberries, spinach, fish, mushrooms, bananas , and melons

Potassium is regulated by what organ?

the kidneys

Potassium helps maintain what two things in the body?

blood pressure and fluid balance

what is calcium’s job in the body?

stabilize neuron excitability

what causes hypocalcemia? (10)

hypoparathyroidism, thyroidectomy, pancreatitis (releases calcium and calcitonin), loop diuretics, laxatives, long term steroids, phenytoin, GI wounds, phosphate enemas, Chronics diseases

what doe phosphate enemas do in the body

high phosphate, low calcium and magnesium

chronic diseases such as (3) cause hypocalcemia

celiac, crohns, and CKD

what does low phosphorate, low vitamin D, and low magnesium do?

hypocalcemia

what is calcitonin

puts a ton of calcium in the bones

what can we do to help hypocalcemia? (5)

give foods high in calcium, calcium acetate, IV calcium, Oral calcium with vitamin D and magnesium hydroxide

what do we need to watch out for when giving Calcium acetate?

what for phosphate levels and EKGS

Food we should encourage for Hypocalcemia (6)

give dairy, sardines, canned salmon, leafy greens, tofu, and edamame

foods we should restrict for hypercalcemia (6)

dairy, sardines, canned salmon, leafy greens, tofu, and edamame

what causes hypercalcemia (4)

hyperparathyroidism, antacids with calcium (TUMS), malignant cancer cells, low phosphate

what can we do to help hypercalcemia (8)

diet, fall risk, calcium reabsorption inhibitors, IV phosphate, IV normal saline (kidney stones), monitor EKG and urine output, Loop diuretics

what is the last resort to help hypercalcemia

DIALYSIS

what are calcium reabsorption inhibitors (3)

calcitonin, aspirin, NSAIDS

what causes hypernatremia (10)

overproduction of aldosterone, high sodium intake (IV/oral), GI tube feeding, Hypertonic solutions in excess, corticosteroids (sodium excretions decreases), loss of fluid (too much salt left in body) , dehydration, infection, diarrhea, and diabetes insipidus

Diet for hypernatremia (10)

canned foods, frozen dinner, fried foods, tomate sauce, cheese, salad dressing, salty rice cakes, pizza/ hot dogs, chips/ lunch meat.

what can we do to help hypernatremia (4)

restrict sodium intake, patient safety , IV isotonic or hypotonic solution (cells are salty and shrink) , educate on diet

why do we give IV isotonic or hypotonic solution (cells are salty and shrink) slowly for hypernatremia?

risk for cerebral edema

what causes hyponatremia (4)

high sodium excretion (renal problems, NG suction, vomiting, sweat, diurretics), overload fluids diluted (CHF, hypotonic fluids, liver failure), sodium intake is insufficient (DIET/NPO), ADH oversecreting

what can we do to help hyponatremia (5)

diet, watch HR/ RR/ GI/ RENAL/ NEURO, give IV hypertonic fluids, restrict fluids/ diuretics, antidiuretic hormone antagonist

when giving IV hypertonic fluids for hyponatremia what is the risk and what is it hard on?

risk for fluid overload and hard on veins

what do we watch for in patients on lithium

watch for drug levels (low sodium = high lithium)

diet for hyponatremia

salty foods in moderation

should we give relomycin with food

NO never give with food

what causes hypomagnesemia (4)

excessive alcohol (stops GI from taking magnesium), fluid loss (NG suction, diuretics), antibiotic (aminoglycosides), pregnant mothers at risk for malnutrition

what can we do to help with hypomagnesemia (5)

diet, assess reflexes, assess respiratory rate, assess swallowing muscles, IV magnesium sulfate

when giving IV magnesium sulfate what do we need to do and look at (2) for hypomagnesemia

give very slowly and look at labs

diet for hypomagnesemia (11)

chocolate, cauliflower, veggies, avocados, peas, bananas, oranges, milk, peanut butter, pork, nuts

what diet not to give for hypermagnesemia

do not give chocolate, cauliflower, veggies, avocados, peas, bananas, oranges, milk, peanut butter, pork, nuts

what causes hypermagnesemia (4)

diabetic ketoacidosis, antacids with magnesium (TUMS), renal failure, hyperkalemia

what can we do to help hypermagnesemia (4)

diet, hemodialysis, monitor labs and DTRS, IV calcium gluconate (will lowe muscle tension and tightness)

what does magnesium maintain in the body (3)

immune system, bones and BG