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Electrolytes

Electrolytes

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Published by Martha Marty Balint
electrolytes for nurses
electrolytes for nurses

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Published by: Martha Marty Balint on Oct 22, 2010
Copyright:Attribution Non-commercial

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12/24/2012

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1
Electrolytes
Sodium: Na+
Serum: 135-145 for adults Panic: <115Function:
MAJOR: maintain extracellular volume (fluid distribution)
90% of DCF cations = Na+
Low Na+ leads to a dilution of ECF which pushes water into cells
High Na+ pulls water out of cells which leads to cellular dehydration
Other functions: maintains body fluid osmolarity
Neuromuscular responses (nerve/muscle impulses)
Acid-Base balance regulation
KIDNEYS regulate Na+ via ALDOSTERONE
Cerebral cells are v. sensitive to NA
Hyponatremia: below 135 
SX:
Thirst and decreased urine output
Concentrated urine (dark yellow)
Confusion, decreasedconsciousness/restlessness, no tears,no sweat, hallucinations, convulsions,fatigue, coma
Increased heart rateTX:
replace Na and fluid loss through diet or IV fluid
When below 125, bring up the valuequickly to 125 then let it increase slowlyto normal levels
Isotonic saline, lactated ringers.
Hypernatremia: above 145 
SX:
irritability,
sometimes interspersed with lethargy,
 
2
Electrolytes
altered senses,
seizures,
fever,
excessive dieresis,
oligoanuria
low skin turgor,
thirst,
confusion,
neuromuscular excitability,
seizure,
coma,
Tachycardia, (including orthostatictachycardia.),
hypotension,
Tachypnea,
confusion,
Poor capillary refill.
volume depletion from fluid losses,
Diuretic therapy, renal/adrenal disease.TX:
Gradually lower serum Na+ level todecrease the risk of cerebral edema.
Infusion of 0.9% NS or 0.45Na+D5W, or diuretics.
Potassium (K+)
Test: Serum: 3.5-5.5
Function:
Water balance INSIDE cell
Convert glucose to glycogen
Store N in muscle CHON and energyproduction
Release insulin from Islets of Langerhans
Lowers BP when high against Na+
Hypokalemia:
Below 3.5Causes: alkalosis, GI, renal loss, high perspiration, poor dietary intakeSX:
fatigue,
muscle weakness,
DIMINISHED DEEP TENDONREFLEXES,
anorexia,
 
3
Electrolytes
N&V,
irritability,
sensitivity to digitalis,
EKG changesTX:Mild: dietary increase or oral supplementsSevere: (below 2.0) IV PB Never 
, never, never push K 
Hyperkalemia:
Above 5.5
Seldom w/normal renal function
Conditions that can cause: renal failure, burns, crush injuries, acidosis, diureticsSX:
ECG changes,
Vague muscle weakness
Flaccid paralysis
Anxiety
Nausea
Cramping
DiarrheaTX:
restrict dietary in mild cases incl.discontinue supplements
IV Ca gluconate for cardio if necc,
IV bicarbonate (alkalize plasma and shiftK to cells)
Peritoneal dialysisECG: WIDENS QRS, prolongs PR and VENTRICULAR DYSRHYTHMIAS
Phosphorus (HPO 
4
+)
Test: Serum: 2.7-4.5
Function:
Essential to all cells
Role in metabolism of CHO, CHON,Fats
Essential to energy (formation of ATPand ADP)
Cellular building block – nucleic acids,essential to cell membrane formation
O
2
delivery, function in formation of RBC
Fyi: 80% HPO
4
in body in teeth andboons, 40% in ICF.

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