Hyponatremia is:
Low sodium concentrations in the blood.
Hyponatremia occurs when there is sodium loss such as from:
vomiting, diarrhea, or excessive intake of water that dilutes the sodium excessively.
Hyponatremia occurs when sodium level in extracellular fluid drops below:
135 mEq/L.
With Hyponatremia the body attempts to:
compensate by decreasing water excretion.
Signs and Symptoms of Hyponatremia depend:
on the underlying cause.
In hyponatremia sodium floods into the cell and shifts:
potassium out of the cell causing a potassium imbalance also.
Signs and symptoms of a potassium imbalance are:
weakness, anorexia, muscle cramps, confusion, fatigue, headache, edema, seizures.
Treatment for hyponatremia is:
sodium replacement and water restrictions.
Hypernatremia is the:
concentration of sodium is greater than normal.
Hypernatremia occurs when sodium exceeds:
145 mEq/L.
The body attempts to resolve hypernatremia by:
conserving water through renal absorption.
Hypernatremia causes fluid to shift from the cells to the:
interstitial spaces, which results in dehydration and interruption of cell processes.
A potassium imbalance occurs with hypernatremia because:
potassium is excreted.
Signs and symptoms of Hypernatremia are:
dry mucous membranes, low urine output, firm rubbery turgor, restless, agitated, confused, flush.
Treatment for hypernatremia is to:
gradually lower the sodium levels by decreasing sodium intake or by increasing water in the body.
Hypokalemia is a:
decrease in the bodys potassium level less than 3.5 mEq/L..
The normal range of potassium is narrow and any decrease:
has profound consequences.
The major cause of potassium loss is:
renal excretion.
The kidneys do not conserve potassium and will:
excrete it when it is in need.
Interstitial fluids contain a large amount of:
potassium.
Excessive GI loss from gastric suctioning, or prolonged vomiting:
will deplete potassium.
Severe diarrhea, fistulas, ileostomy, and excessive diaphoresis will cause:
a potassium loss.
Use of diuretics depletes:
potassium.
Strenous exercise releases potassium from the cells and into:
the interstitial spaces and ultimately excreted by the kidneys.
Hypokalemia has the capacity to affect:
skeletal and cardiac functions.
The resulting muscle weakness from potassium loss:
can cause life threatening cardiac conduction abnormalities.
Treatment of hypokalemia involves:
replacing the potassium with IV potassium, supplements, monitoring kidney and cardiac function until potassium levels become normal again.
Hyperkalemia is the increase:
in the bodys serum potassium level greater than 5 mEq/L.
The major cause for hyperkalemia is:
renal disease; in which the potassium is not excreted adequately.
When tissue damage occurs potassium:
is released from cells raising potassium.
If kidney output is reduced there will be an:
elevation in potassium. 1
Hyperkalemia is also caused by excessive intake of:
sodium.
Too many potassium supplements, beta blockers and potassium sparing diuretics will result in:
elevated potassium. 2
Chemotherapy, ACE inhibitors, NSAID's and aminoglycosides will result in:
elevated potassium 3
Hyperkalemia is less common then:
hypokalemia.
Hyperkalemia is dangerous because overstimulation:
to the heart muscle can lead to serious cardiac dysrhythmias.
Treatment of Hyperkalemia is:
restricting potassium intake, Giving calcium gluconate to decrease the effects of high potassium on the heart.
Giving sodium bicarbonate or insulin in a glucose solution will:
shift the potassium back into the cell.
Kayexalate:
sodium polystyrene sulfonate orally and rectally binds with potassium in order to remove potassium through the gi tract.
Hypochloremia:
Occurs when chloride levels fall below 96 mEq/L in association with sodium loss.
Sodium and Chloride are frequently:
paired.
Vomiting, diarrhea, gastric suctioning and acute infections all cause:
a loss of both sodium and chloride.
Symptoms of hypochloremia are:
depressed respirations, tetany, alkalosis.
Treatment of hypochloremia includes:
alleviating underlying cause and replacing chloride with sodium chloride IV solution.
Hyperchloremia:
is rare; can occur when bicarbonate levels fall and metabolic acidosis occurs.
The increase in chloride anions mean:
an attempt to compensate and maintain equal numbers with cations in the body fluid.
Because Chloride imbalances rarely occur without the imbalance of another electorlyte there are:
no known signs or symptoms.
Symptoms of acidosis may indicate:
high chloride levels.
Hypocalcemia:
develops when the serum level of calcium falls below 4.5 mEq/L.
Symptoms of Hypocalcemia involve:
neuromuscular irritation and increased excitability manifested by deep tendon reflexes and seizures.
With hypocalcemia, neuromuscular symptoms increase:
Tetany, laryngeal spasms, stridor, trousseau sign, chvostek sign.
Hypocalcemia treatment involves:
replacing calcium with IV calcium gluconate and oral 1000mg supplements daily.
If decreased calcium is due to decreased PTH:
increasing that hormone will have to be dealt with.
Hypercalcemia:
occurs when calcium levels exceed 5.6 mEq/L.
Hypercalcemia can happen when:
serum calcium levels drop and the bones release calcium into the blood to compensate.
Immobile patients may release:
calcium from their bones into the blood.
Hypercalcemia is also caused by excessive intake of:
Vitamin D and calcium supplements.
Hypercalcemia symptoms are:
neuromuscular activity depression, as well as the formation of renal calculi as a result of excreting high levels of calcium in the kidneys.
Hypophosphatemia:
very rare low phosphate levels.
Hypophophatemia may be a result of:
dietary insufficiency, impaired kidney function or maldistribution of phosphorus.
Low phosphate levels have been associated with:
muscle weakness, especially the respiratory muscles, bone and joint pain, and disorientation with confusion.
Treatment of hypophosphatemia involves:
replacing the phosphorus with oral or IV supplements and monitoring patient.
Hyperphosphatemia is:
also very rare.
Hyperphosphatemia occurs with:
renal insufficiency but can occur with an increased intake of phosphate and vitamin D.
Hyperphosphatemia symptoms are:
tetany, numbness and tingling sensation around the mouth, muscle spasms.
The usual treatment for hyperphosphatemia is:
reducing phosphorus intake and treating the underlying cause.
Phosphate binding gels such as:
aluminum hydroxide and IV calcium supplementation may be needed for hyperphosphatemia.
Hypomagnesemia:
develops when blood levels fall less than 1.5 mEq/L.
A decrease in mag is also associated with a:
decrease in potassium levels, because the kidneys tend to conserve magnesium by excreting potassium.
Hypomagnesemia causes symptoms of:
increased neuromuscular irritability similar to those of hypocalcemia. tremors, cramping, numbness and tingling sensation in the hands and feet, disorientation, confusion, tetany, seizures.
The major cause of low magnesium is
increased excretion by the kidneys.
Hypomagnesemia treatment is:
Oral or IV magnesium.
Hypermagnesemia develops when:
magnesium levels exceed 2.5 mEq/L.
Hypermagnesemia rarely occurs when:
kidney function is normal.
With insufficient kidney function excess magnesium administration and:
diabetic ketoacidosis with severe water loss may develop.
An excess of magnesium severely restricts:
nerve and muscle activity, and causes respiratory depression, hypotension and potentially cardiac arrest.
Treatment of Hypermagnesemia involves:
decreasing magnesium intake while supporting cardiac and respiratory function.
Dialysis may be necessary to:
remove excess magnesium from the blood.