Electrolyte Imbalances

Pathophysiology Course

TEST TIP The MOST deadly conditions are typically the MOST tested conditions, since the main goal of nursing school
is to create safe nurses.

Electrolytes Function HYPER ‘’HIGH’’ Hypo ‘’low’’

Potassium K+ HYPERkalemia HYPOkalemia

P (over 5.0) (below 3.0)
3.5 - 5.0 Priority
Manifestations (S/S)
Heart = HIGH pumps
P ITY P 1 - Peaked T Waves & ST Elevation
Manifestations (S/S)
Heart = Low & slow pump
Potassium PR IOR Pumps the heart 2 - Severe: V Fib & Cardiac Arrest Causes: - Renal failure 1 - Flat T waves, ST depression & Uwave
Potassium 3 - Hypotension & Bradycardia - Low Aldosterone Neuromuscular = Low & slow Causes:

K+
Neuromuscular = HIGH 1 - Shallow Respirations! Most DEADLY Fluid Loss/Electrolyte Loss
Memory Trick for AL 2 - Decreased DTR
Potassium 1 - Increased DTR “Where fluids flow, Electrolytes Goooo!”
A - Adds Sodium
K+
3 - Muscle cramping & flaccid paralysis
2 - Paralysis & paresthesia (tingling) (paralyzed limbs)
Diarrhea, Diuretics,
3 - Muscle Weakness (General Feeling
L - Loses Potassium Diet, DKA, Aldosterone
GI = Low & slow
of heaviness) 1 - Constipation
2 - HypOactive bowel sounds
GI = HIGH pumps 3 - Paralytic ileus (paralyzed intestine)
1 - Diarrhea Priority* risk for SBO
2 - Hyperactive bowel sounds

S
Sodium Na+ Sodium
HYPERnatremia HYPOnatremia
135 - 145 Sodium
(over 145) (below 135)
Maintains: Na+
• Blood Pressure Manifestations (S/S) Causes: Manifestations (S/S) Causes:
Body = Big & Bloated - Low ADH (antidiuretic hormone) Brain = Low & Slow - Sweating
Sodium • Blood volume S 1 - Edema (swollen body) DI: Diabetes Insipidus
1 - Headache = Cerebral edema - Excess water intake

Na+
2 - Mental status changes (running in the extreme heat) TEST TIP
• pH balance Swells the body with FLUID 2 - Flushed “red & rosey” skin Think Dry Inside 3 - Seizures & Coma - SIADH (Excess ADH
3 - Increased muscle tone - Rapid respirations Muscular = Low & slow - Vomiting & diarrhea,
4 - Swollen dry tongue - Watery diarrhea - Fatigue & muscle cramps - Diuretics & Diuresis
- Diet low in salt
5 - Nausea & Vomiting - Loss of thirst Respiratory = Low & slow - Low aldosterone
- Respiratory Arrest

Chloride Cl- HYPERchloremia HYPOchloremia

(over 107) (below 97)
NORMAL

97 - 107
HIGH
LOW

Related to sodium Chloride Chloride

Maintains: Cl- Cl-

NEARLY SAME
• Blood pressure AS HIGH SODIUM
Chloride NEARLY SAME AS low SODIUM
• Blood Volume

Cl-
1 - Swollen dry tongue 1 - Fatigue & muscle cramps
• pH balance 2 - Nausea & vomiting 2 - Fever (only difference)
pH

Alkalosis - vomiting

Magnesium Mg+ HYPERmagnesemia HYPOmagnesemia

1.3 - 2.1 M M (over 2.1) (below 1.3)
Magnesium Mellows the muscles
Manifestations (S/S)
Heart = High Mellow Manifestations (S/S)
Magnesium Causes: Heart = Low Mellow - Excited!
Magnesium 1 - Heart block,

Mg+
1 - Torsades de Pointes TOP TESTED
2 - Hypotension, Bradycardia - Renal failure

Mg+
& V Fib (ventricular fibrillation) Causes:
DTR = High Mellow - Alcoholism DTR = Low Mellow - Excited! - Crohn's disease
- Hyporeflexia (decreased DTR) - Malnourishment - HYPERreflexia (increased DTR) - Celiac disease
Lungs & GI = High Mellow GI = Low Mellow - Excited!
- Depressed respirations - Diarrhea
- Hypoactive bowel sounds - Hyperactive bowel sounds

Calcium Ca C HYPERcalcemia HYPOcalcemia

Keeps the Calcium

9.0 - 10.5 3 Bs Strong Calcium

(over 10.5) (below 9.0)
B - Bone
B - Blood (clotting) Ca Manifestations (S/S) Manifestations (S/S)
B - Beats (heart) HIGH Calm Causes: Low Calm = Excited!
Calcium C 1 - Kidney stones, moans & 1 - T - Trousseau’s Sign Causes:

Ca
- Hyperparathyroidism Twerking arm when BP cuff on -Hypoparathyroidism
Inverse Contracts the muscles groans (Renal Calculi) High PTH = High Calcium Tetany: muscle spasms all over
2 - C - Chvostek’s Sign
Low PTH = Low Calcium
2 - Constipation - Cancer, - Renal failure TEST TIP
relationship with 3 - Bone Pain - Immobility
Cheek smile when stroking face
3 - Diarrhea Chronic kidney disease (CKD)
Calcium
4 - Weak B’s
4 - Severe muscle weakness Weak Bones = Fractures
Weak Blood clotting = r/f bleeding
& lethargy Weak Beats = Cardiac dysrhythmias

Phosphate - Ca HIGH = HYPERphosphatemia HYPOphosphatemia

Phosphate Low
3.0 - 4.5 - Ca Low = (over 4.5) (below 3.0)
Phosphate HIGH
Manifestations (S/S)
Manifestations (S/S) Think High Calcium signs Causes:
Calcium
Think Low Calcium signs Causes: - Hyperparathyroidism

Ca
1 - Kidney stones, moans & groans
1 - Trousseau’s & Tetany - Renal failure TEST TIP (Renal Calculi) High PTH = High Calcium
2 - Chvostek's Chronic kidney disease (CKD) 2 - Constipation - Genetics
3 - Bone Pain - Cancer
3 - Weak B’s (bones, blood, beats)
Calcium 4 - Severe muscle weakness & lethargy

Ca