Electrolyte Imbalance s

Hypocalcemia: Ca (4.0-6.0 mg/dl)

Hypocalcemia- a low bood calcium

level, occurs when the concentration of free calcium ions in the blood falls below 4.0 mg/dL (dL = one tenth of a liter). The normal concentration of free calcium ions in the blood serum is 4.0-6.0 mg/dL.

Hypocalcaemia: Ca (4.0-6.0mg/dl)
S&S TREATMENT NURSING

Abdominal and muscle cramps Lethargy BP Tetany Seizure ECG changes

Calcium gluconate Given by physician or NP on general 10% : 1 g in 50care units and by 100ml of D5W over 1 RNs in ICU. hr, then infusion of Do not infuse too 1-2 mg/kg/hr.

rapidly- is cardiotoxic and can cause BP. Never given IM or subcutaneouslycauses severe sloughing of tissue. Check calcium and magnesium levels.
Antidote: IV magnesium sulfate.

Hypercalcemia: Ca (9-10.5 mg/Dl)

Hypercalcemia- the presence of

abnormally high levels of calcium in the blood.

Hypercalcemia: Ca (9-10.5 mg/dL)

S&S TREATMENT NURSING

Dehydration Renal Stones Confusion Severe thirst Constipation Polyuria Shortening of QT interval BP.

D5NS at 250-500 mL/hr; furosemide 20-80 mg IV over 2 min to bring Ca down with diuresis.

Monitor electrolyte levels. Encourage fluid intake. Provide fiber diet and stool softeners. Potentiate digoxin toxicity; assess as indicated. Monitor ECG, if available, or assess pulse for irregular beats.

Hypomagnesemia Mg (1.5 - 2.5 mg/dL. )

Hypomagnesemia

abnormally low magnesium content of the blood.

Hypomagnesemia Mg (1.5 - 2.5 mg/dL. )

S&S TREATMENT NURSING

Weakness Vertigo Muscle twitching Tachycardia Seizures Tetany PVCs

2 g magnesium sulfate in D5W over 10-20 min, then 1 g/hr for 3-4 hr.

Check other electrolyte levels Can have potassium phosphate calcium Assess reflexes and monitor Mg levels.

Hypermagnesemia Mg(1.5-2.5 mEq/L.)

Hypermagnesemia-

is an electrolyte disturbance in which there is an abnormally elevated level of magnesium in the blood. Usually this results in excess of magnesium in the body.

Hypermagnesemia Mg(1.5-2.5 mEq/L.)

S&S TREATMENT NURSING

Nausea Vomiting BP Weakness Hyperreflexia HR Coma Respiratory failure

Calcium gluconate Assess for 10%: 1-10ml in 50-100 changes in LOC. ml of D5W over 10 Assess reflexes 20 minutes. Hold medications containing magnesium, especially in patients with renal failure.

Hypophosphatemia (2.5-4.5 mg/dL)

Hypophosphatemia-

is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood

Hypophosphatemia (2.5-4.5 mg/dL)

S&S TREATMENT NURSING

Anorexia Weakness muscle pain Confusion Rhabdomyolysi s Hemolysis Cardiac and respiratory failure

Potassium or sodium phosphate 2 mg/kg IV over 6 hr if P04 level is <1-5 mg/Dl.

Too rapid IV administration can cause severe hypocalemia Assess for tetany

Hyperphosphatemia (2.5-4.5 mg/dL)

Hyperphosphatemia-

is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood.

HyperphosphatemiaMg(1.5-2.5 mEq/L.)
S&S TREATMENT Phosphate binders, possibly acetazolamide, low phosphate diet. NURSING Teach patient about avoiding foods and OTC medications high in phosphorus.

Limited sypptoms Possible tetany if calcium is low, which is a result of hyperphosphater mia

Hyperkalemia (3.5 and 5.0 mEq/L)

Hyperkalemia

- refers to the condition in which the concentration of the electrolyte potassium (K+) in the blood is elevated

 S&S

Malaise Palpitations muscle weakness mild hyperventilation

The patient may have: Muscular weakness Cardiac dysrhythmias ECG Abnormalities ( tall, peaked T waves)

Hypokalemia (3.5 to 5.0 mEq/L)

Deficiency

of potassium in the bloodstream.

Hypernatremia (136-145 mM)

excessive

blood.

amounts of sodium in the

Hyponatremia (136-145 mM)

is

an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal

Hyperglycemia
is

a condition in which an excessive amount of glucose circulates in the blood plasma

Hypoglycemia
Deficiency

of glucose in the bloodstream.