Electrolyte Disorders: Signs & Symptoms
Electrolyte
Deficit [HYPO]
Excess [HYPER]
Sodium (Na+)
135-145 mEq/L
(mmol/L)
Hyponatremia [SEIZURE PRECAUTIONS]
↓ CNS function: irritability, apprehension, confusion,
personality ∆s, tremors, tremors, seizures, coma, dry
mucosa
CV ∆s: postural HoTN; ↓CVP; ↓JV filling; ↑HR; thread
pulse; cold clammy skin
Hypernatremia [SEIZURE PRECAUTIONS]
Intense thirst, Dry swollen tongue, sticky mucosa
↓ CNS function: restless, agitiation, seizures, twitching, coma
CV ∆s: postural HoTN
Potassium (K+)
3.5 – 5.0 mEq/L
(mmol/L)
Hypokalemia [CARDIAC MONITOR]
Fatigue, muscle weakness, leg cramps, N/V, polyuria,
hyperglycemia; paralytic ileus, soft flabby muscles
ECG changes: ↓HR; ST depression, flat T wave; weak
irregular pulse; Ventricular arrhythmias (PVCs, VTach,
VFib)
CNS ∆s: ↓reflexes, paresthesias
Hyperkalemia [CARDIAC MONITOR]
Diarrhea, ABD cramping, hypoglycemia
ECG ∆s: VFib or standstill, irregular pulse; cardiac arrest (if
sudden & severe); tall peaked T waves, prolonged PR, loss of P
wave, widened QRS
CNS ∆s: Irritability, anxiety, lower extremity weakness,
paresthesias, irregular pulse
Magnesium (Mg2+)
1.8-3.0 mEq/L
(mmol/L)
Hypomagnesemia
CNS ∆s: ↑reflexes, tetany, neuromuscular irritability
• Hallmark sign of chronic alcoholism
• Resembles Hypocalcemia
Hypermagnesemia
↓ CNS function: lethargy, drowsiness, somnolence
↓ Neuromuscular function: ↓reflexes, N/V, cannot walk
• Respiratory & cardiac arrest
Calcium (Ca2+)
8.8-10.5 mg/dL
Hypocalcemia [AIRWAY PROTECTION]
Fatigue, depression, anxiety
CNS ∆s: Tetany, Chvostek/Trousseau signs, twitching,
confusion, numbness, tingling (lips, fingers & toes),
↑reflexes, cramps, laryngeal spasm, seizures
ECG ∆s: lengthened ST, prolonged QT, VTach
Hypercalcemia
Thirst, bone pain/fractures, polyuria, dehydration,
nephrolithiasis; ↑ Interstitial (tissue) fluid
↓ CNS function: lethargy, weakness, ↓reflexes, ↓memory,
confusion, personality ∆s, psychosis, stupor/coma, anorexia, N/V
ECG ∆s: ↓ST, ↓QT; Ventricular dysrhythmias, ↑Digoxin effect
Phosphate (PO4-)
2.5-5.0 mg/dL
Hypophosphatemia
↓ CNS function: confusion, coma, muscle weakness
(respiratory weakness, difficulty weaning from a
mechanical ventilator); renal tubular wasting of Mg, Ca,
HCO3, Cardiac issues (dysrhythmias, SV); osteomalecia,
rhabdomyolysis
Hyperphosphatemia
Creates hypocalemia: muscle problems; tetany
CaPO4 precipitates in the skin, soft tissue, cornea, vicera, and
blood vessels
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