Electrolyte Imbalances
Electrolyte
Sodium
135-145
Hypo or Hyper
Hyponatremia
Hypernatremia
Potassium
3.5-5
Hypokalemia
Hyperkalemia
Calcium
9-10.5
Hypocalcemia
Hypercalcemia
Magnesium
1.5-2.5
Phosphorus
2.5-4.5
Symptoms/Signs
Causes
Treatment
Weakness, lethargy,
seizures, headache,
muscle cramps, twitching,
hypotension
Same symptoms as
dehydration (dry mucus
membranes, neuro
symptoms….), seizures
Muscle cramps, muscle
weakness, paresthesia,
flattened T waves,
decreased bowel motility,
cardiac arrhythmias
Paralysis, muscle
weakness, cardiac
arrhythmias, peaked T
waves, increased bowel
motility
GI loss, SIADH, NPO,
water intoxication,
medication
Restrict fluids, give
sodium, seizure
precautions
Dehydration, burn, DI
Restrict sodium, give
fluids, daily weights,
I&O’s, seizure
precautions
Potassium chloride,
cardiac monitoring,
Potassium sparing
diuretics, renal failure,
acidosis
IV dextrose with insulin.
If there is EKG changes
(like peaked T waves)
give calcium gluconate,
kayexalate, dialysis,
cardiac monitoring
positive trousseau’s
(carpal spasm) and
Chvostek’s (facial
twitching), tetany (tingling
in hands/feet/mouth),
seizures, cardiac
dysfunction
***
Hyporeflexia, lethargy,
cardiac dysrhythmias,
bone pain, renal stone
Thyroidectomy,
parathyroidectomy, vit
D deficiency, GI loss
Calcium Gluconate,
seizure precautions,
cardiac monitoring
Hyperparathyroidism,
dehydration, vitamin D
excess, dehydration,
immobilization
Alcohol abuse,
inadequate nutritional
intake, increased loss
via GI/renal
Renal failure, adrenal
insufficiency, laxative
overdose
Renal excretion, alcohol
abuse, DKA,
hypomagnesemia,
antacids, TPN, burns
Renal failure, chemo,
excessive use of
laxatives, acidosis
Cardiac monitoring,
fluids, dialysis,
medications (diureitcs)
Hypomagnesemia
Same as hypocalcemia,
cardiac abnormalities
Hypermagnesemia
Decreased DTR,
flushed/warm skin, cardiac
abnormalities
muscle weakness,
seizures, chest pain, bone
pain
Hypophosphatemia
Hyperphosphatemia
Same as hypocalcemia
Diuretics, diarrhea,
prolonged NGT
suctioning.
Magnesium sulfate,
seizure precautions,
Mechanical ventilation,
medications (diuretics),
fluids
Oral phosphate,
increase intake, seizure
precaution
Aluminum hydroxide,
hydration, dialysis,
seizure precaution