NUR105 - Electrolyte Imbalances

Electrolytes

Ions that create electricity or energy to help our body maintain normal functioning.

• Where fluids flow, these go!

• Help maintain fluid balance

VPPS (vomiting, pee, poop, sweat)

What depletes electrolytes?

Potassium (3.5-5.0)

• KING

• maintains heart and muscle contraction

Hyperkalemia (>5.0)

signs and symptoms: tight & contracted

• Heart: ST elevation & peak T waves; V-fib or cardiac standstill; hypotension & bradycardia

• GI Tract: diarrhea, hyperactive bowel sounds

• Neuromuscular: paralysis in extremities, increased DTRs, profound muscle weakness

Hypokalemia (<3.5)

signs and symptoms: low & slow

• Heart: flat T waves, ST depression, prominent U waves

• Muscular: decreased DTRs, flaccid paralysis, muscle cramping

• GI: decreased motility, hypoactive bowel sounds, constipation, abdominal distention; paralytic ileus (paralyzed intestine)

Sodium (135-145)

Functions to maintain:

• blood pressure

• blood volume

• pH balance

Hypernatremia (>145)

Signs and symptoms: big and bloated

• Skin: flushed, edema, low grade fever

• Polydipsia

• Late: Swollen dry tongue, N/V, increased muscle tone

Hyponatremia (<135)

signs and symptoms: depressed & deflated

• neuro: seizures and coma

• heart: tachycardia & weak thready pulses

• respiratory arrest

Chloride (98-106)

Exact same functions as sodium!

Maintain:

• blood pressure

• blood volume

• pH

Hyperchloremia (>107)

same as high sodium

• nausea and vomiting

• swollen dry tongue

• confusion

Hypochloremia (<97)

same as low sodium

• excessive diarrhea, vomiting, and sweating

• fever!

Magnesium (1.3-2.1)

• Sheriff

• functions to maintain law and order in the muscles

• calms down the muscles and keeps the peace

• Required for calcium and Vit D absorption

Hypermagnesemia (>2.1)

signs and symptoms: calm & quiet

• cardiac: heart block, prolonged PR intervals, bradycardia, hypotension

• DTRs: decreased

• Lungs: depressed and shallow respirations

• GI: hypoactive bowel sounds

Hypomagnesium (<1.3)

signs and symptoms: buck wild!

• heart: torsade de points, ST depression, T wave inversion, V-fib, tachycardia

• DTRs: hyperreflexia, incresed reflexes

• Eyes: abnormal eye movements, nystagmus

• GI: diarrhea

Calcium (9-10.5)

cocky

• functions to keep bones, blood, and heart beats strong

Hypercalcemia (>10.5)

signs and symptoms: moans, groans, and stones

• constipation

• bone pain

• stones: renal calculi

• DTRs: decreased, severe muscle weakness

Hypocalcemia (<9.0)

Signs & Symptoms:

• Trousseau’s sign (blood pressure cuff twitch)

• Chvostek’s sign (smile when stroking cheek)

• Diarrhea

• Circumoral tingling

• weak bones

• risk for bleeding

• cardiac dysrhythmias

Phosphorus (3-4.5)

• calcium’s worst enemy

• does the opposite of calcium (if calcium is high, phosphate is low, vice versa)

• important for bone and teeth formation

• helps regulate calcium