Term
Sodium (Na) Normal range: 135-145 mEq/L
Hyponatremia (low Na)
- Common causes: diuretics, GI fluid loss, hypotonic tube feeding, D5W or hypotonic IV fluids, diaphoresis
- S&S: anorexia, nausea, vomiting, weakness, lethargy, confusion, muscle cramps, twitching, seizures, Na < 135 mEq/L
- Tx: - Restrict fluid (safer)
- If IV saline solutions prescribed, administer very
slowly; use isotonic saline if fluid restriction not effective |
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Definition
Hypernatremia (high Na)
- Common causes: water deprivation, hypertonic tube feeding, diabetes insipidus (DI), heat stroke, hyperventilation, watery diarrhea, renal failure, Cushing syndrome
- S&S: Thirst, hyperexia, sticky mucus membranes, dry mouth, hallucinations, lethargy, irritability, seizures, Na > 145 mEq/L
- Tx: - Restrict Na in diet
- Beware of hidden sodium in foods/meds
- Increase water intake |
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Term
Potassium (K) Normal range: 3.5-5.0 mEq/L
Hypokalemia (low K)
- Common causes: diuretics, diarrhea, vomiting, gastric suction, steroid administration, hyperaldosteronism, Amphotericin B, bulimia, Cushing syndrome
- S&S: fatigue, anorexia, nausea, vomiting, muscle weakness, decreased GI motility, dysrhythmias, paresthesia, flat T waves on EKG, K < 3.5 mEq/L
- Tx: - Administer K supplements orally or IV
- PO forms are unpleasant tasting and irritating to
the GI tract (do NOT give on empty stomach; dilute)
- NEVER give IV bolus/push; must be well diluted
- Assess renal status; i.e., urinary output prior to
administering. NO PEE, NO K
- Encourage foods high in K (bananas, oranges,
spinach, avocado, cantaloupe) |
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Definition
Hyperkalemia (high K)
- Common causes: hemolyzed serum sample produces pseudohyperkalemia, oliguria, acidosis, renal failure, Addison disease, multiple blood transfusions
- S&S: multiple weakness, bradycardia, dysrhythmias, flaccid paralysis, intestinal colic, tall T waves on EKG, K >5.0 mEq/L
- Tx: - Eliminate parenteral K from IV infusions/meds
- Administer 50% glucose w/regular insulin
- Administer cation exchange resin (Kayexalate =
think K exits to reduce K)
- Monitor EKG
- Administer calcium gluconate to protect the heart
- IV loop diuretics may be prescribed
- Renal dialysis may be required |
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Term
Calcium (Ca) Normal range: 8.5-10.5 mEq/L
Hypocalcemia (low Ca)
- Common causes: renal failure, hypoparathyroidism, malabsorption, pancreatitis, alkalosis
- S&S: diarrhea, numbness, tingling of extremities, convulsions, + Trousseau's sign, Ca < 8.5-10.5 mEq/L, at risk for tetany
- Tx: - Administer Ca supplements PO 30 min AC
- Administer calcium IV slowly, infiltration can cause
tissue necrosis
- Increase Ca intake (e.g., dairy products, greens) |
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Definition
Hypercalcemia (high Ca)
- Common causes: hyperparathyroidism, malignant bone disease, prolonged immobilization, excess calcium supplementation
- S&S: muscle weakness, constipation, anorexia, nausea, vomiting, polyuria, polydipsia, necrosis, dysrhythmias, Ca >10.5 mEq/L
- Tx: - Eliminate parenteral calcium
- Administer agents such as calcitonin to reduce Ca
- Avoid Ca-based antacids
- Renal dialysis may be required |
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Term
| Magnesium (Mg) Normal range: 1.5-2.5 |
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Definition
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