pathopharm electrolyte review

symptoms: lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures

SLOW mental function

hyponatremia (low sodium)

caused by: suctioning, diuretics, excessive perspiration (hot weather or physical work), prolonged diarrhea or vomiting, renal disorders

hyponatremia (low sodium)

symptoms : water retention (edema→ found in ECF and pulls water out of cell, leaving cells dehydrated), hypertension, red flushed skin, dry and sticky mucous membranes, increased thirst, elevated temp, decreased urine output

hypernatremia (high sodium)

caused by: poor resale excretion stemming from kidney malfunction, inadequate water intake and dehydration

hypernatremia (high sodium)

sodium range

135-145 mEg/L

caused by: decreased intake, increased loss (GI loss, diuretics), shift out of cells by insulin or alkalosis

hypokalemia (low potassium)

symptoms: muscle weakness and fatigue, decreased neuromuscular excitability, smooth muscle atony (constipation, ileus), cardiac dysrhythmias, flattened T waves and prominent U waves on ECG

NON-excitable muscles

hypokalemia (low potassium)

treatment: oral or IV replacement, treat underlying cause

hypokalemia (low potassium)

caused by: decreased renal excretion (renal failure), shift out of cells (acidosis, tissue injury), excess intake. hypoaldosteronism

hyperkalemia (high potassium)

symptoms: tingling, muscle cramps, diarrhea, muscle weakness, flaccid paralysis, cardiac dysrhythmias, peaked T waves on ECG

excitable muscles

hyperkalemia (high potassium)

treatment : IV calcium gluconate (stabilizes cardiac membranes), insulin with dextrose (shifts into cells), sodium bicarbonate (if metabolic acidosis), nebulizer albuterol (optional adjunct), loo diuretics , binding agent, dialysis to remove it

hyperkalemia (high potassium)

potassium range ?

3.5- 5.5 mEq/L

calcium range?

8.8-10.5 mg/dL

caused by: inadequate intake or absorption, hypoparathyroidism, vitamin D deficiency, blood transfusions (citrate binding)

hypocalcemia

symptoms: increased neuromuscular excitability, muscle cramps and tetany, positive Chvostek and Trousseau signs, seizures/convulsions, cardiac dysrhythmias (prolonged QT interval)

hypocalcemia

treatment: oral supplement, IV calcium gluconate, vitamin D supplementation, correct underlying cause

hypocalcemia

caused by: hyperparathyroidism, malignancy, excess vitamin D intake, prolonged immobilization

hypercalcemia

symptoms: decreased neuromuscular excitability, muscle weakness, lethargy or confusion, constipation, kidney stones, cardiac dysrhythmias (shortened QT interval)

hypercalcemia

treatment: IV normal saline, loop diuretics (after hydration), bisphosphonates, calcitonin, corticosteroids, dialysis (severe and refractory cases)

hypercalcemia

phosphate range?

2.0-4.7 mg/dL

caused by: malnutrition or intestinal malabsorption, vitamin D deficiency, chronic alcoholism, refeeding syndrome, antacid use (aluminum or magnesium containing), hyperparathyroidism

hypophosphatemia

symptoms : muscle weakness, respiratory muscle weakness/failure, bone pain and osteomalacia, confusion or altered mental status, impaired leukocyte and platelet function (increase infection and bleeding risk)

hypophosphatemia

treatment: oral phosphate replacement, IV phosphate replacement, correct underlying cause

hypophosphatemia

caused by: chronic kidney disease, excess phosphate intake or phosphate contains laxatives/enemas, tumor lysis syndrome or rhabdomyolysis, hypoparathyroidism

hyperphosphatemia

symptoms: often asymptomatic, signs of hypocalcemia (tetany, muscle cramps, paresthesia)

hyperphosphatemia

treatment: restrict dietary phosphate, phosphate binders, treat underlying cause, dialysis for severe or refractory hyperphosphatemia

hyperphosphatemia

magnesium range?

1.5-3.0 mg/dL

caused by: malnutrition or malabsorption, chronic alcoholism, gastrointestinal losses, renal losses, associated with hypocalcemia and hypokalemia

hypomagnesemia

symptoms: increased neuromuscular excitability, hyperreflexia, muscle cramps and tremors, tetany or seizures, nystagmus, cardiac dysrhythmias (including tornadoes de pointes)

hypomagnesemia

treatment: oral supplementation, IV magnesium sulfate, correct underlying cause

hypomagnesemia

caused by: renal insufficiency or kidney failure, excess magnesium intake (antacids, laxatives, supplements)

hypermagnesemia

symptoms: decreased neuromuscular excitability, diminished or absent deep tendon reflexes, muscle weakness, hypotension, Brady cardia, respiratory depression, cardiac arrest

hypermagnesemia

treatment: discontinue containing meds, IV calcium gluconate, IV fluids and loop diuretics, dialysis for severe toxicity or renal failure

hypermagnesemia