SODIUM (NA+) 135-145 HYPERNATREMIA HYPONATREMIA "BIG AND BLOATED" FLUSHED SKIN EDEMA LOW GRADE FEVER EXCESSIVE THIRST LATE SERIOUS SIGNS: -SWOLLEN DRY TONGUE -GI (NAUSEA AND VOMITING) -INCREASED MUSCLE TONE "DEPRESSED & DEFLATED" NEURO CHANGES TACHYCARDIA WEAK, THREADY PULSE PATIENT COULD GO INTO RESPIRATORY DESTRESS Na+ and K+ are OPPOSITES SODIUM'S FUNCTIONS: MAINTAINS BLOOD PRESSURE BLOOD VOLUME PH BALANCE POTASSIUM (K+) 3 .5 -5 HYPERKALEMIA HYPOKALEMIA HYPOTENSION, DECREASED DTR BRADYCARDIA MUSCLE CRAMPING DIARRHEA FLACCID PARALYSIS HYPERACTIVE BOWEL HYPOACTIVE BOWEL SOUNDS SOUNDS PARALYSIS IN EXTREMITIES CONSTIPATION INCREASED DTR ABDOMINAL DISTENTION PROFOUND MUSCLE PARALYTIC ILEUS WEAKNESS POTASSIUM IS RESPONSIBLE FOR HEART AND MUSCLE CONTRACTION WORDS SUCH AS "PROFOUND" AND "SEVERE" ARE LATE SYMPTOMS AND SHOULD BE ASSESSED FIRST! IMBALANCES CAN CAUSE CARDIAC ARRYTHMIAS AND NEUROMUSCLUAR DYSFUNCTION Na+ and K+ are OPPOSITES NEVER ADMINISTER K+ THROUGH IV PUSH, IM, OR SUB-Q! ALWAYS DILUTE CHLORIDE 9 6 -1 0 6 HYPERCHLOREMIA NEARLY SAME AS HIGH NA+ NAUSEA AND VOMITING SWOLLEN DRY TONGUE CONFUSION DEEP BREATHING FUNCTIONS: MAINTAINS BLOOD PRESSURE BLOOD VOLUME PH BALANCE HYPOCHLOREMIA NEARLY THE SAME AS LOW NA+ EXCESSIVE DIARRHEA, VOMITING, SWEATING FEVER (ONLY DIFFERENCE) WHERE SODIUM GOES, CHLORIDE FOLLOWS MAGNESIUM 1. 3 -2 .1 HYPERMAGNESEMIA HYPOMAGNESEMIA HIGH EVERYTHING (AS IF PT. IS NOT SEDATED) LOW EVERYTHING (AS NYSTAGMUS SEDATED) HYPERREFLEXIA HYPOACTIVE BOWELS HYPERACTIVE BOWELS SHALLOW RESPIRATIONS POSITIVE TROUSSEAU'S HYPOREFLEXIA AND CHVOSTEK'S SIGNS DYSPHAGIA DELUSIONS FUNCTIONS: REGULATES BP, BLOOD SUGAR, MUSCLE CONTRACTION, AND NERVE FUNCTION THINK ABOUT MG AS A SEDATIVE! MAGNESIUM IS REQUIRED FOR: CALCIUM VIT. D ABSORPTION MAGNESIUM AND CALCIUM ARE PROPORTIONAL WITH EACH OTHER MG INCREASES/DECREASES WITH CA2+ CALCIUM 9 -1 0 .5 HYPERCALCEMIA HYPOCALCEMIA "SWOLLEN AND SLOW" TROUSSEAU'S SIGN CONSTIPATION CHVOSTEK'S SIGNS BONE PAIN DIARRHEA KIDNEY STONES CIRCUMORAL TINGLING DECREASED DTR RISK FOR FRACTURE SEVERE MUSCLE INCREASED BLEEDING WEAKNESS CARDIAC ARRTHYMIAS FUNCTIONS: KEEPS BLOOD, BONES, AND BEATS STRONG Co=Mg Ca & PO=opposites Patient's with a Ca imbalance are at higher risk for pathologic fractures, so move patient slowly and carefully! PHOSPHATE 9 -1 0 .5 HYPERPHOSPHATEMIA HYPOPHOSPHATEMIA TROUSSEAU'S SIGN "SWOLLEN AND SLOW" CHVOSTEK'S SIGNS CONSTIPATION DIARRHEA BONE PAIN CIRCUMORAL TINGLING KIDNEY STONES RISK FOR FRACTURE DECREASED DTR INCREASED BLEEDING SEVERE MUSCLE CARDIAC ARRTHYMIAS WEAKNESS FUNCTIONS: BONE AND TEETH FORMATION HELPS REGULATE CALCIUM Ca & PO=opposites Insulin therapies can lower Phosphate levels! Chemotherapy can cause hyperphosphatemia.
