Imbalance
Hyponatremia
Hypernatremia
Lab Value
Range
-Serum Na+
below 136
mEq/L
-Serum
Osmalality
below 285 m
mL/kg
Blood sodium
levels, > 145
mEq/L
Hypokalemia
Blood
potassium
level > 5.0
mEq/dL
Hypercalcemia
Total blood
calcium level
< 1.3 mEq/dL
Hypomagnesimia
Blood
magnesium <
1.3 mEq/L
Hypermangesemia
Blood
magnesium
level >2.1
mEq/L
Risks
Expected Findings
Pt Care Considerations
Low ECF volume,
edema,
hyperglycemia,
skin losses,
ascites
+/-/= ECF volume, O.
H., rapid pulse,
confusion, DTRs,
seizures, anorexia,
N/V, hyperactive
bowel sounds
Monitor I and O, daily
weight, vitals and LDC,
oral/IV fluids
NPD, heat
stroke, excessive
sodium intake or
retention, fluid
loss
Increased
potassium, ECF
shift, hypertonic
states,
decreased
potassium
excretion, age
Thiazide diuretic,
long term
glucocorticoid
Hyperthermia,
tachycardia, O. H.,
confusion, ECG
disturbances, N/V,
constipation, anxiety
Slow, irregular pulse,
hypotension,
irritability, confusion,
paresthesia, diarrhea,
hyperactive bowel
sounds
Monitor LDC and ensure
safety, provide oral
hygieneencourage
fluids. Diuretics if kidney
is impaired.
Continuous ECG
monitoring; decrease
potassium intake,
administer IV fluids
Decreased reflexes,
bone pain,
dysrhythmia, blood
clots, N/V, weakness,
lethargy
Increased nerve
transmission,
hyperactive bowels,
dysrhythmias,
tachycardia,
hypertension, PVC’s
Diminished reflex,
decreased
respirations, cardiac
changes, lethargy
Restrict calcium intake
increase fluid intake
monitor patient for
pathological fractures
Increased
magnesium
output
inadequate
intake or
absorption
Kidney or
adrenal
impairment,
meds
Discontinue Magnesium
losing meds, oral or IV
magnesium
replacement, diet
changes
Frequent focused
assessment, loop
diuretics, calcium
gluconate for severe
cardiac changes
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