table 27.2: blood electrolyte imbalances

electrolytes

sodium

chloride

potassium

calcium

phosphate

magnesium

normal sodium blood plasma levels

136-148 mEq/liter

chloride normal blood plasma levels

95-105 mEq/liter

potassium normal blood plasma levels

3.5-5.0 mEq/liter

calcium normal blood plasma levels

total= 9.0-10.5 mg/dL

ionized= 4.5-5.5 mEq/liter

phosphate normal blood plasma levels

1.7-2.6 mEq/liter

magnesium normal blood plasma levels

1.3-2.1 mEq/liter

deficiency in sodium

hyponatremia

hyponatremia causes

decreased sodium intake

increased sodium loss through vomiting, diarrhea, aldosterone deficiency, or taking certain diuretics

excessive water intake

hyponatremia signs and symptoms

muscular weakness

dizziness

headache

hypotension

tachycardia and shock

mental confusion

stupor

coma

excess sodium

hypernatremia

hypernatremia causes

dehydration

water deprivation

excessive sodium in diet or iv fluids

hypernatremia leads to

hypertonicity of ECF which pulls water of body cells into ecf causing cellular dehydration

hypernatremia signs and symptoms

intense thirst

hypertension

edema

agitation

convulsions

chloride deficiency

hypochloremia

hypochloremia causes

excessive vomiting

overhydration

aldosterone deficiency

congestive heart failure

therapy with certain diuretics such as furosemide (Lasix)

hypochloremia signs and symptoms

muscle spasms

metabolic alkalosis

shallow respirations

hypotension

tetany

excess chloride

hyperchloremia

hyperchloremia causes

dehydration due to water loss or water deprivation

excessive chloride intake

severe renal failure

hyperaldosteronism

certain types of acidosis

some drugs

hyperchloremia signs and symptoms

lethargy

weakness

metabolic acidosis

rapid deep breathing

potassium deficiency

hypokalemia

hypokalemia causes

excessive loss due to vomiting or diarrhea, decreased potassium intake, hyperaldosteronism, kidney disease, and therapy with some diuretics

hypokalemia signs and symptoms

muscle fatigue

flaccid paralysis

mental confusion

increased urine output

shallow respirations

changes in ecg like flattening of t wave

excess potassium

hyperkalemia

hyperkalemia causes

excessive potassium intake

renal failure

aldosterone deficiency

crushing injuries to body tissues

transfusion of hemolyzed blood

hyperkalemia signs and symptoms

irritability

nausea

vomiting

diarrhea

muscular weakness

hyperkalemia can lead to

death by inducing ventricular fibrillation

calcium deficiency

hypocalcemia

hypocalcemia causes

increased calcium loss

reduced calcium

hypocalcemia signs and symptoms

numbness and tingling of fingers

hyperactive reflexes

muscle cramps

tetany

convulsions

bone fractures

spasms of laryngeal muscles that can cause death by asphyxiation

excess calcium

hypercalcemia

hypercalcemia causes

hyperparathyroidism

some cancers

excessive intake of vitamin D

Paget’s disease of bone

hypercalcemia signs and symptoms

lethargy

weakness

anorexia

nausea

vomiting

polyuria

itching

bone pain

depression

confusion

paresthesia

stupor

coma

phosphate deficiency

hypophosphatemia

hypophosphatemia causes

increased urinary losses

decreased intestinal absorption

increased utilization

hypophosphatemia signs and symptoms

confusion

seizures

coma

chest and muscle pain

numbness and tingling of fingers

decreased coordination

memory loss

lethargy

excess phosphate

hyperphosphatemia

hyperphosphatemia causes

kidneys fail to excrete excess phosphate as in renal failure

increased intake of phosphates

destruction of body cells which releases phosphates into blood

hyperphosphatemia signs and symptoms

anorexia

nausea

vomiting

muscular weakness

hyperactive reflexes

tetany

tachycardia

magnesium deficiency

hypomagnesemia

hypomagnesemia causes

inadequate intake or excessive loss in urine or feces

alcoholism

malnutrition

diabetes mellitus

diuretic therapy

hypomagnesemia signs and symptoms

weakness

irritability

tetany

delirium

convulsions

confusion

anorexia

nausea

vomiting

paresthesia

cardiac arrhythmias

excess magnesium

hypermagnesemia

hypermagnesemia causes

renal failure

increased intake of magnesium such as magnesium containing antacids

aldosterone deficiency

hypothyroidism

hypermagnesemia signs and symptoms

hypotension

muscular weakness or paralysis

nausea

vomiting

altered mental functioning