K
controls cellular osmotic pressure
K
activates enzymes
K
Regulates acid-base balance
K
Maintains nerve and muscle function
K
influences kidney regulation
K
influences sugar uptake
hyperkalemia
initially vague muscle weakness (usually large muscles of the lower extremities)
hyperkalemia
skeletal muscle weakness progressing to paralysis
hyperkalemia
paresthesias & dysrhythmias
hypokalemia
initially vague fatigue & generalized malaise
hypokalemia
muscle weakness
hypokalemia
paresthesias
hypokalemia
diminished deep tendon reflexes
hypokalemia
hypotension & cardiac dysrhythmias
Na
influences distribution of water
Na
maintains acid-base balance
Na
maintains nerve function
Hypernatremia
thirst, dry mucous membranes
Hypernatremia
flushed dry skin
Hypernatremia
hypotension if accompanied by FVD
Hypernatremia
neurological findings (due to dehydration of the brain cells)
- weakness
- lethargy
- irritability
Hypernatremia
spasticity, seizures
Hypernatremia
in extreme cases coma and death
hyponatremia
anorexia, nausea, and abdominal muscle cramping
hyponatremia
neurologic dysfunction ( due to cellular swelling)
- headache
- lethargy
- seizures
hyponatremia
possibly resulting in coma, respiratory arrest, and death
hyponatremia
optic disk swelling (papilledema)
hyponatremia
sternal edema
Ca
major component of bones and teeth
Ca
affects permeability of cell membranes
Ca
plays a role in blood coagulation
Ca
maintenance of heart beat
Ca
affects nerve function
hypercalcemia
dysrhythmias & HTN
hypercalcemia
muscular weakness
hypercalcemia
depressed reflexes
hypercalcemia
altered LOC progressing to coma
hypocalcemia
dythrhythmias & hypotension
hypocalcemia
tetany ( muscle spasms)
hypocalcemia
parensthesias, altered mood, confuion, seizures
Mg
thought to be needed in activation of enzymes
Mg
aids in some neuromuscular functions
Hypermagnesemia
weakness, diminished deep tendon reflexes, muscle weakness
Hypermagnesemia
hypotension with peripheral vasodilation
Hypomagnesemia
hyperexcitability with muscle weakness
Hypomagnesemia
tremors & generalized seizures
Hypomagnesemia
apathy, confusion
Hypomagnesemia
delirium, vertigo
Hypomagnesemia
ataxia ( defective muscle coordination), coma, dysrhythmias
Hypomagnesemia
symptoms difficult to identify because of simultaneous hypocalcemia and hypokalemia
Cl
plays a role in acid-base balance
Cl
helps to maintain water balance
hyperchloremia
usually associated with hypernatremia and metabolic acidosis
hypochloremia
usually associated with deficit of sodium and potassium, and metabolic alkalosis
P
component of bone
P
involved in most metabolic processes
Hyperphosphatemia
few symptoms caused by an excess of this excess mineral alone
Hyperphosphatemia
deposit of calcium and phosphate salts around joints and soft tissues causing pain on movement
Hypophosphatemia
anemia, infections, bleeding
( because of impaired function ans survival time of RBC's, WBC's & platelets)
Hypophosphatemia
muscle weakness: including respiratory and cardiac muscles
Hypophosphatemia
irritability & parensthesias progressing to coma
Hypophosphatemia
renal symptoms
Hypophosphatemia
symptoms RT loss of Mg & bicarbonate
Hypophosphatemia
hyperalcalciuria ( excessive Ca in urine)
Hypophosphatemia
osteomalacia, rickets
K
3.5- 5.0
Na
135-145
Ca
9-10.5
Mg
1.5-2.5
Cl
98-106
P
2.5-4.5
Respiratory acidosis
an increase of carbon dioxide in the blood
Metabolic acidosis
a deficit of bicarbonate ions, or excess of H ions due to renal disease
Respiratory acidosis
pneumonia, emphysema, asthma, overdose of drugs causing respiratory depression/ hypoventilation
Respiratory acidosis
Tx of choice is Tx of underlying condition
Metabolic acidosis
LR or bicarbonate may be ordered
Metabolic acidosis
uncontrolled DM
Metabolic acidosis
fasting, starvation (anorexia, bulimia)
Metabolic acidosis
lactic acidosis
Metabolic acidosis
aspirin overdose, alcoholic ketoacidosis
Metabolic acidosis
kidney dysfunction and failure
Metabolic acidosis
diarrhea, intestinal suctioning, fistulas
Metabolic acidosis
low Ph, low bicarbonate
Metabolic acidosis
diarrhea, nausea, vomitting, anorexia
Metabolic acidosis
weakness, lethargy, malaise, altered LOC, coma
Metabolic acidosis
peripheral vasodilation, shock
Metabolic acidosis
cardiac dysrhythmias, low HR
Metabolic acidosis
warm and flushed skin
Metabolic alkalosis
excessive ingestion of bicarbonate
Metabolic alkalosis
high Ph, High bicarbonate
Metabolic alkalosis
- TPN solutions containing acetate
- Parenteral solutions containing lactate
- Blood transfusions containing citrate
Metabolic alkalosis
vomiting, gastric suctioning, bulimia, diuretic therapy
Metabolic alkalosis
loss of chloride and body fluid
Metabolic alkalosis
confusion, hyperactive reflexes, tetany, convulsions, hypotension, dysrhythmias
respiratory acidosis
sedative overdose, head trauma
respiratory acidosis
lung disorders
- pneumonia
- emphysema
- asthma
- pulmonary edema
- RDS
- airway obstruction
- respiratory muscle paralysis
respiratory acidosis
extreme obesity, kyphoscoliosis
respiratory acidosis
low Ph, high PCO2
respiratory acidosis
hypoventilation, shallow respirations
respiratory acidosis
headache, weakness, altered LOC,
respiratory acidosis
behavioral changes
- disorientation
- confusion
- depression
- paranoia
- hallucinations
respiratory acidosis
tremors, paralysis, stupor, coma
respiratory acidosis
warm dry skin, drowsiness
respiratory acidosis
nausea and vomiting, diarrhea, fruity smelling breath, acidic blood and urine
respiratory alkalosis
high Ph, Low PCO2
respiratory alkalosis
hysteria, hyperventilation
respiratory alkalosis
high fever, aspirin poisioning
respiratory alkalosis
high blood ammonia levels, encephalitis, mechanical ventilation
respiratory alkalosis
deep respirations with rapid breathing
respiratory alkalosis
irritability, panic, lightheadedness, dizziness
respiratory alkalosis
parenthesia, seizures, positive Chvostek & trousseau,
respiratory alkalosis
nausea, vomiting, diarrhea, alkaline urine
respiratory alkalosis
ECG changes, muscle twitching, tetany, tremors
respiratory alkalosis
Tx involves use of rebreathing mask or breathing into a paper bag to increase CO2 reuptake
pH
7.35-7.45
Paresthesia
an ominous sign of electrolyte loss particularly ionized Ca loss
CO2
35-45
Bicarbonate
22-26
edema
HF, Thrombophlebitis, Liver Cirrhosis cause increased venous pressure and...
edema
low protein due to malnutrition or liver disease causes..
edema
Poor lymphatic drainage causes..
edema
sodium retention due to kidney or endocrine disorders can cause...
edema
Inflammation can cause..
edema
Physical stress such as from surgery can cause...
Hypernatremia
most commonly caused by water loss and consuming too much sodium
Hypernatremia
occurs with diabetes insipidus, or insensible water loss ( hyperventilation, serious burns)
Hyponatremia
May be caused by
- an excess production of ADH
- Pulmonary disorders
- pneumonia
- asthma
- oat cell carcinoma
- ARF
- Lymphoma
- Leukemia
- Hodgkin disease
Hyponatremia
May be due to
- diuretic therapy
- renal disease
- adrenal insufficiency
- Loss of GI fluids
- low sodium diet
- inappropriate PO or IV fluid intake (D10W)