Electrolytes

1. Hypernatremia

   Nota:

   • >145 R/t increased sweating,poor intake, DI
   1. Low BP, Dry mucous membranes, UO <30mL/hr,Disoriented, irritable
      1. Tx:NS-o.5 NS. Decrease NA slowly to prevent cerebral edema
   2. >145
   3. Profuse sweating, poor intake, DI
      1. FVD
2. Hyponatremia
   1. Increased BP, potential cerebral edema,FVE,Weakness, hemiparesia, ataxia, muscle cramps, Taste changes, confusion.
      1. Fluid restriction or NS- depends on cause
   2. <136
      1. IV dextrose, poly dispsia, SIADH
3. 135-146mEq.L

1. Chloride follows sodium. Tx sodium-->Tx chloride
2. 96-110mEq/l

1. Hyperkalemia
   1. EKG changes, cardiac arrest, muscle weakness, flaccid paralysis, nausea
      1. Tx: Bicarb, IV dextrose/insulin, kayelexate
         1. NEVER GIVE k+ as IVP
            1. ALWAYS KNOW PTS POTASSIUMS LEVELS BEFORE ADMIN
               1. CARDIAC MONITORING IF GIVING GREATER THAN 20 MeQ/HR& ICU
   2. >5.5mEq
   3. Too much replacement, trauma, renal failure
2. 3.5-5mEq/L
3. HypoKalemia
   1. <3.5mEq
      1. GI/Renal loss; K+ shifting intracellulary b/c of glucose or alkalosis
         1. Fatigue, muscle weakness, slow reflexes, flaccid parralysis, Cardiac arrythmias, N/V
            1. Tx- Replacement

Nota:

• 9.0-10.5 mEq/L

1. Hypercalcemia
   1. Lethargy, Confusion, Muscle weakness, nausea
      1. Tx: IVF, furosemide
   2. Hyperparathyroidism
   3. Too Many calcium antacids
   4. Cancers- esp.Bone
   5. >10.5mEq/L
2. Hypocalcemia
   1. Trousseaus sign-palmar flexion. Chvosteks sign- cheek
   2. >8.5mEq/L
   3. Hypoparathyroidism,lack of vit. d, citrate in blood products
3. 9.0-10.5mEq/l

1. 1.3-2.1mg/dL

1. 3.0-4.5mg/Dl