Sodium Na+ CNS changes

Normal Range 135 145 mEq/L

Hypo Causes: hypotonic tube foods, head injury, SIADH. Symptoms confusion, tired, abdominal cramping, increased urination, crave salty foods, seizures Interventions :administer saline, give salty foods (canned veggies). Dietary always first. Causes: vomiting, heavy perspiration, K wasting drugs (some diuretics) poor intake of K. S&S: cardiac arrythmias, leg cramps (big one), lethargy, decreased GI motility, decreased bowel sounds, decreased tendon reflexes, lethargy, depressed T wave on EKG. Treatment: give K Causes: hypoPTH, acute pancreatitis, hyperphosphatemia, inadequate vitamin D intake. Signs: weak bones, bad teeth, circum oral numbness, +Trousseau & Chvostek sign, severe muscle cramping, muscle tremors, can progress to convulsions, decrease cardiac output, cardiac disrythmias, hyperactive DTR. Dietary Causes: lots time use of certain drugs (diuretics), loss from GI tract. Signs: neuromuscular irritability with tremors, increased reflexes, tachycardia, disorientation and confusion, anorexia, difficulty swallowing, respiratory difficulties. Extreme most often in maternity patient have convulsions. Treatment: foods high in Mg

Hyper Causes: fluid loss (diarrhea), water deprivation, too much saline solution or table salt, heat stroke. Symptom: crave water, dry sticky mucous membranes, weakness (more common here than with hypo), in severe cases: convulsions, decreased level of consciousness. Interventions: increase water intake, decrease sodium intake. Causes: diarrhea, renal failure, K sparing diuretics, hypoaldesteronism. Sx: cardiac arrest, muscle weakness, irregular pulses, GI hyperactivity Treatment: limit K intake, increase fluids, give K exolate enema, give K wasting diuretic, dialysis in renal patient. Causes: hyperPTH. Symptoms: lethargy and weakness, bone pain, decrease DTR, constipation, renal stones, heart block. Treatment: increase fluid intake and fiber, limit calcium-rich foods, encourage movement, acid-ash diet (cranberries, prunes) helps prevent stone formation Causes: Epsom salts (some abuse as laxatives), renal failure and adrenal patients at risk. Signs: vasodilatation, nausea, vomiting, muscle weakness or paralysis, hypotension, bradycardia, decreased DTR, respiratory depression or coma, respiratory and cardiac arrest. Treatments: fluids, safety precautions due to potential changes in level of consciousness, monitor vital signs closely.

Foods Salty foods

Potassium K+ Cardiac changes

3.5 5.0 mEq/L

potatoes, carrots, meat, fish, tomatoes, avocado.

Total Calcium Ca 2+ Neuro changes

8.5 10.5 mg/L

vitamin D, dairy products, dark green leafy vegetables

Magnesium

Mg2+ Neuro changes

1.5 2.5 mEq/L

green leafy vegetables, fish, legumes, whole grains, best source is dried fruits .

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