Nurse Sarah Mnemonics for fluid and electrolytes

Flashcards covering the signs, symptoms, and causes of common electrolyte imbalances.

Hypernatremia

High sodium levels in the blood, leading to cell shrinkage. Causes include Cushing's Syndrome, Conn’s syndrome, hypertonic solutions, corticosteroids, dehydration, diabetes insipidus, burns, and increased sodium intake. Symptoms include flushed skin, fever, restlessness, increased reflexes, edema, extreme thirst, dry mouth/skin, and decreased urinary output.

Hyponatremia

Low sodium levels in the blood, leading to cell swelling. Causes include decreased sodium consumption, diuretics, vomiting, diarrhea, Addison’s disease, SIADH, fluid overload, CHF, hypotonic fluids, and renal failure. Symptoms include seizures, stupor, abdominal cramping, lethargy, diminished tendon reflexes, trouble concentrating, loss of urine/appetite, orthostatic hypotension, overactive bowel sounds, and shallow respirations.

Hyperchloremia

High chloride levels in the blood. Causes are similar to hypernatremia (excessive sodium intake, hypotonic fluids, dehydration), Conn’s syndrome, decreased bicarbonate, corticosteroids, and metabolic acidosis. Symptoms are similar to hypernatremia and acidosis.

Hypochloremia

Low chloride levels in the blood. Causes include cystic fibrosis, burns, GI issues (vomiting, ileostomy), thiazide diuretics, and metabolic alkalosis. Symptoms are similar to dehydration.

Hyperkalemia

High potassium levels in the blood. Causes include burns, tissue damage, Addison's disease, renal failure, rhabdomyolysis, and medications like potassium-sparing diuretics, ACE inhibitors, and NSAIDs. Symptoms include muscle weakness, decreased urinary output, respiratory failure, decreased cardiac contractility, muscle twitches/cramps, and rhythm changes (tall peaked T waves, prolonged PR intervals).

Hypokalemia

Low potassium levels in the blood. Causes include loop diuretics, corticosteroids, excessive insulin, Cushing's syndrome, starvation, and fluid loss (vomiting, GI issues). Symptoms: Lethargy, low shallow respirations, lethal cardiac dysrhythmias, lots of urine, leg cramps, limp muscles, low BP and heart rate.

Hypercalcemia

High calcium levels in the blood. Causes include hyperactive parathyroid, increased vitamin D or calcium supplements, cancer spreading to bones, and medications like thiazides and lithium. Symptoms include muscle weakness, EKG changes (shortened QT interval), absent reflexes, altered mental status, abdominal distension, and kidney stone formation.

Hypocalcemia

Low calcium levels in the blood. Causes include decreased PTH, low calcium intake, low vitamin D, CKD, bisphosphonates, aminoglycosides, and anticonvulsants. Symptoms include convulsions, hyperactive reflexes, arrhythmias (prolonged QT interval), muscle spasms (tetany), positive Trousseau’s/Chvostek’s signs, and paresthesia.

Hypermagnesemia

High magnesium levels in the blood. Causes include decreased renal function and medications like magnesium sulfate. Symptoms include lethargy, EKG changes (prolonged PR/QT intervals, widened QRS complex), absent/diminished tendon reflexes, hypotension, arrhythmias, red/hot face (flushing), GI issues, impaired breathing, and confusion.

Hypomagnesemia

Low magnesium levels in the blood. Causes include calcium or potassium imbalances, malabsorption disorders, alcoholism, and medications like PPIs. Symptoms include Trousseau's and Chvostek's signs, weakness, increased deep tendon reflexes, torsades de pointes, tetany, low calcium and potassium levels, and hypertension.

Hyperphosphatemia

High phosphate levels in the blood. Causes include phosphate laxatives, increased vitamin D levels, rhabdomyolysis, and hypoparathyroidism. Symptoms include convulsions, hyperactive reflexes, arrhythmias, muscle spasms (tetany, seizures), pruritus, and positive Trousseau's and Chvostek's signs.

Hypophosphatemia

Low phosphate levels in the blood. Causes include aluminum antacids, starvation/refeeding syndrome, overactive parathyroid, and low vitamin D. Symptoms include bone pain/fractures, osteomalacia, neurological changes (irritability, confusion, seizures), and erythrocyte destruction.

Hypernatremia

High sodium levels in the blood, leading to cell shrinkage. Causes include Cushing's Syndrome, Conn’s syndrome, hypertonic solutions, corticosteroids, dehydration, diabetes insipidus, burns, and increased sodium intake. Symptoms include flushed skin, fever, restlessness, increased reflexes, edema, extreme thirst, dry mouth/skin, and decreased urinary output.

Hyponatremia

Low sodium levels in the blood, leading to cell swelling. Causes include decreased sodium consumption, diuretics, vomiting, diarrhea, Addison’s disease, SIADH, fluid overload, CHF, hypotonic fluids, and renal failure. Symptoms include seizures, stupor, abdominal cramping, lethargy, diminished tendon reflexes, trouble concentrating, loss of urine/appetite, orthostatic hypotension, overactive bowel sounds, and shallow respirations.

Hyperchloremia

High chloride levels in the blood. Causes are similar to hypernatremia (excessive sodium intake, hypotonic fluids, dehydration), Conn’s syndrome, decreased bicarbonate, corticosteroids, and metabolic acidosis. Symptoms are similar to hypernatremia and acidosis.

Hypochloremia

Low chloride levels in the blood. Causes include cystic fibrosis, burns, GI issues (vomiting, ileostomy), thiazide diuretics, and metabolic alkalosis. Symptoms are similar to dehydration.

Hyperkalemia

High potassium levels in the blood. Causes include burns, tissue damage, Addison's disease, renal failure, rhabdomyolysis, and medications like potassium-sparing diuretics, ACE inhibitors, and NSAIDs. Symptoms include muscle weakness, decreased urinary output, respiratory failure, decreased cardiac contractility, muscle twitches/cramps, and rhythm changes (tall peaked T waves, prolonged PR intervals).

Hypokalemia

Low potassium levels in the blood. Causes include loop diuretics, corticosteroids, excessive insulin, Cushing's syndrome, starvation, and fluid loss (vomiting, GI issues). Symptoms: Lethargy, low shallow respirations, lethal cardiac dysrhythmias, lots of urine, leg cramps, limp muscles, low BP and heart rate.

Hypercalcemia

High calcium levels in the blood. Causes include hyperactive parathyroid, increased vitamin D or calcium supplements, cancer spreading to bones, and medications like thiazides and lithium. Symptoms include muscle weakness, EKG changes (shortened QT interval), absent reflexes, altered mental status, abdominal distension, and kidney stone formation.

Hypocalcemia

Low calcium levels in the blood. Causes include decreased PTH, low calcium intake, low vitamin D, CKD, bisphosphonates, aminoglycosides, and anticonvulsants. Symptoms include convulsions, hyperactive reflexes, arrhythmias (prolonged QT interval), muscle spasms (tetany), positive Trousseau’s/Chvostek’s signs, and paresthesia.

Hypermagnesemia

High magnesium levels in the blood. Causes include decreased renal function and medications like magnesium sulfate. Symptoms include lethargy, EKG changes (prolonged PR/QT intervals, widened QRS complex), absent/diminished tendon reflexes, hypotension, arrhythmias, red/hot face (flushing), GI issues, impaired breathing, and confusion.

Hypomagnesemia

Low magnesium levels in the blood. Causes include calcium or potassium imbalances, malabsorption disorders, alcoholism, and medications like PPIs. Symptoms include Trousseau's and Chvostek's signs, weakness, increased deep tendon reflexes, torsades de pointes, tetany, low calcium and potassium levels, and hypertension.

Hyperphosphatemia

High phosphate levels in the blood. Causes include phosphate laxatives, increased vitamin D levels, rhabdomyolysis, and hypoparathyroidism. Symptoms include convulsions, hyperactive reflexes, arrhythmias, muscle spasms (tetany, seizures), pruritus, and positive Trousseau's and Chvostek's signs.

Hypophosphatemia

Low phosphate levels in the blood. Causes include aluminum antacids, starvation/refeeding syndrome, overactive parathyroid, and low vitamin D. Symptoms include bone pain/fractures, osteomalacia, neurological changes (irritability, confusion, seizures), and erythrocyte destruction.

Hypernatremia Symptoms: Remember F.R.I.E.D.

Symptoms include flushed skin, fever, restlessness, increased reflexes, edema, extreme thirst, dry mouth/skin, and decreased urinary output.

Hyponatremia Symptoms: Remember S.A.L.T. L.O.S.S.

Symptoms include seizures, stupor, abdominal cramping, lethargy, diminished tendon reflexes, trouble concentrating, loss of urine/appetite, orthostatic hypotension, overactive bowel sounds, and shallow respirations.

Hyperkalemia Symptoms: Remember M.U.R.D.E.R.

Symptoms include muscle weakness, decreased urinary output, respiratory failure, decreased cardiac contractility, muscle twitches/cramps, and rhythm changes (tall peaked T waves, prolonged PR intervals).

Hypokalemia Symptoms: Remember the 7 L's

Symptoms: Lethargy, low shallow respirations, lethal cardiac dysrhythmias, lots of urine, leg cramps, limp muscles, low BP and heart rate.

Hypocalcemia Symptoms: Remember C.R.A.M.P.S.

Symptoms include convulsions, hyperactive reflexes, arrhythmias (prolonged QT interval), muscle spasms (tetany), positive Trousseau’s/Chvostek’s signs, and paresthesia.

Hypermagnesemia Symptoms: Remember L.E.T.H.A.R.G.I.C.

Symptoms include lethargy, EKG changes (prolonged PR/QT intervals, widened QRS complex), absent/diminished tendon reflexes, hypotension, arrhythmias, red/hot face (flushing), GI issues, impaired breathing, and confusion.

Hypercalcemia WEAK

• W – weakness of muscles 

• E – EKG changes (shortened QT interval) 

• A – absent reflexes, altered mental status, abdominal distension 

• K – kidney stone formation 

Hypomagnesemia TWITCH

• T: trousseau and chvostek sign 

• W: weakness 

• I: Inc deep tendon reflex 

• T: torsades de pointes (abnormal heart rhythm)/tetany 

• C: Ca and K levels low 

• H: hypertension 

Hypophosphatemia BONE

• B: bone pain and fractures 

• O: osteomalacia (softening of the bones – leg bowing) (affects growth in children) 

• N: Neuro status changes (irritable, confused, seizures) 

• E: erythrocyte destruction