Pathophysiology: Electrolytes

they are minerals in your blood and body fluids that carry an electric charge

what are electrolytes?

acids, bases, and salts

Name the three types of electrolytes

-cations (positively charged)

-anions (negatively charged)

electrolytes are frequently referred to as ___ or ___

-water in the body

-acid base balance

-muscle function

-and some are essential for energy metabolism

how do electrolytes effect the body? give 4 examples

-sodium: cation

-potassium: cation

-calcium: cation

-magnesium: cation

-phosphorus: anion

-chloride: anion

what are 6 common electrolytes and their electrical charge?

135-145 mEq/L

what is the normal range of sodium

sodium

which electrolyte is the most abundant in the ECF? (95% of it is in the ECF and only 1% is in the cell itself)

sodium

which electrolyte is the regulator of ECF FLUID VOLUME / plasma osmolality. (it can change cell size)

Na/ K pump

what is the transport pump for sodium?

neuromuscular response

sodium plays a major role in the ___

-kidney (90%)

-GI tract/skin (10%)

the dietary intake of sodium is eliminated by the ___ and ___

500mg/ day

how many milligrams of sodium per day can meet the physiologic need?

-vascular volume/ baroreceptors/ SNS

-aldosterone/ ADH

-osmoreceptors/ thirst

-ANP

sodium has a balance regulated by what 4 things?

-hyponatremia: Na < 135 mEq/L

-hypernatremia: Na > 145 mEq/L

what are the two types of sodium imbalances called and their level of sodium?

-osmotic shift from ICF to ECF

-hypovolemic (loss of both H2O and Na)

-euvolemic (loss of Na; normal ECF volume)

-hypervolemic (loss of Na; increased EFC volume

what are 4 ways a hyponatremia imbalence of sodium can occur?

-decrease in aldosterone

-burns

-dilute ingestions

-excessive sweating

-GI loss: vomiting/ diarrhea/ tap H2O enemas

-medications

what are 6 ways that hypovolemic hyponatremia occurs?

-increase ADH

-abuse of "ectasy"

-medications

what are 3 ways that euvolemic hyponatremia can occur?

-heart

-liver

-renal

what are the 3 types of organ failure that hypervolemic hyopnatremia can lead to?

-serum osmolality < 275 mOsm/kg

-hemodilution (H&H/ BUN)

-Gastrointestinal

-cellular shifts

what are the 4 clinical manifestations of hyponatremia?

anorexia, nausea, vomiting, abdominal cramps, diarrhea

what are the 5 gastrointestinal things of hyponatremia?

apprehension, coma, depression, headache, lethargy, muscle cramps, weakness, personality changes, stupor

when a cellular shift occurs during hyponatremia, what is expected to occur?

confused

alterations of sodium will make a patient feel ___

-increased water loss

-decreased water intake

-increased sodium intake (salt water)

what are the 3 things that can cause hypernatremia?

-diarrhea

-sweating

-tachpnea

-hypertonic enternal feedings

-decreased ADH

what are 5 things that are expected when there is a loss of water during hypernatremia?

-unavailable

-inability

-impaired thirst sensation

-restrictions

what 4 things are expected when there is a decrease in water intake with hypernatremia

-serum osmolality > 295 mOsm/kg

-polydipsia

-oliguria/ anuria

-extracellular dehydration

-intracellular dehydration

-cellular shifts

what are the 6 clinical manifestations of hypernatremia?

-tachycardia

-hypotension

what are 2 things that can be expected with the clinical manifestation of extracellular dehydration of hypernatremia?

-dry mucous membranes

-poor skin turgor

-decreased salivation/ tearing

what are 3 things that can be expected with the clinical manifestation of intracellular dehydration of hypernatremia?

-head aches

-agitation/ restlessness

-seizures/ coma

what are 3 things that can be expected with the clinical manifestation of cellular shifts of hypernatremia?

3.5-5.0 mEq/L

what is the normal range for potassium

potassium

what is the most abundant ICF electrolyte

conduction of nerve impulses, cardiac conduction, skeletal muscle contraction, smooth muscle

potassium regulates neuromuscular excicitability such as:

acid/ base balence

potassium plays a role in regulating ___ balence

diet

where is potassium mostly obtained from

-kidneys

-cellular shift

serum potassium balance is regulated by what 2 things

-renal conservation/ elimination

-aldosterone

-K+ and H+ exchange in kidneys

what is being regulated in the kidneys from serum potassium balance?

-Na/K pump

-osmolality

-acidosis/ alkalosis

-insulin facilitates cellular uptake

what is being regulated in the cellular shift from serum potassium balance?

8.5 - 10.5

what is the normal range for calcium balance?

-99% in bones

-1% in plasma/ IFC

where is calcium found?

-skeletal strength/ stability

-available source to extracellular CA uptake

what are 2 ways that calcium in the bones is beneficial

-40% is bound to plasma proteins

-50% is ionized (free)- free to exit EFC compartment and engage in cellular function

where is the 1% of calcium in the plasma/ EFC found?

-neuronal excitability

-effects membrane potential

-contraction of skeletal, cardiac, and smooth muscle

-role in hormone release, neurotransmitters

-role in cardiac automaticity and contractility

-NECESSARY FOR BLOOD CLOTTING

what are the 6 ionized Ca functions?

small intestines

calcium is found in dietary sources (milk products) and 30-50% is absorbed from ___

kidneys

calcium is excreted from the ___

PTH and Vitamin D

calcium balance is regulated by ___

2.5-4.5 mg/dL

What is the normal range for phosphorus?

-85% in bone

-14% intracellular

-1% extracellular

where is phosphorus found throughout the body?

-bone formation

-metabolic process such as ATP formation and formation of enzymes necessary for glucose/ fat/ and protein metabolism

-component of DNA/ RNA

-part of phospholipid cell membrane

-acid-base buffer

-necessary for normal functions of WBC and platelets

what are the 6 functions of phosphorous

milk/ meat

what dietary sources can phosphorous be found?

small intestines

where is phosphorous absorbed?

kidneys

phosphorous is eliminated by the ___

PTH

Ca

___ plays a role in phosphorous balance and has an inverse relationship with ___

1.8-3.0 mg/dL

what is the normal range of magnesium?

-50-60% in bone

-40-50% intracellular

-1% extracellular

where can magnesium be found in the body?

-intracellular enzyme reactions

what reaction does magnesium play a role in?

-cellular energy metabolism

-DNA/ RNA

what 2 things is magnesium essential for?

Na/K pump

magnesium plays a role in what pump

K+ and Ca+

magnesium decreases are associated with decreases in ___

kidneys

how is magnesium eliminated?

PTH

renal tubular reabsorption of Mg is stimulated by ___

dietary intake

how do we receive magnesium which is absorbed by the intestines and eliminated by the kidneys

lost

in isotonic fluid deficit, water and electrolytes are ___ in proportional amounts

retained

in isotonic fluid excess, water and electrolytes are ___ in proportional amounts

hypovolemia

vascular

___ is fluid deficit that result sin compromise of blood circulating the ___ compartment

hypervolemia

___ is fluid excess