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Electrolyte Imbalances

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gotcelloskills's version from 2016-10-20 21:24

Summary

This page helps you learn about the different electrolyte imbalances, their causes, and how to identify them.

Common Causes

Question Answer
Hypokalemiaalkalosis, treatment of diabetic KA with insulin, diarrhea, vomiting, GI losses, diuretics, aldosterone excess, polyuria, glucocorticoid therapy
Hyperkalemiarapid infusion of stored blood, excess salt substitute ingestions, massive cellular damage (chemo), DKA
HypocalcemiaVitamin D deficiency (end stage renal disease), chronic diarrhea, laxative misuse, steatorrhea, hypoparathyroidism, rapid administration of citrated blood, hypoalbuminemia, alkalosis, pancreatitis, hyperphosphatemia
Hypercalcemiamilk-alkali syndrome, prolonged immobilization, hyperparathyroidism, bone tumors, use of thiazide diuretics
Hypomagnesemiamalnutrition, chronic alcoholism, chronic diarrhea, laxative misuse, steatorrhea, rapid admin of citrated blood, Gi losses, thiazide or loop diuretics, aldosterone excess
Hypermagnesemiaexcessive use of laxatives and antacids, parenteral overload, oliguric end-stage renal disease, adrenal insufficiency
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Physical Examination

Question Answer
Hypokalemiabilateral muscle weakness, ab distension, decreased bowel sounds, constipation, dysrhythmias
Hyperkalemiabilateral muscle weakness, ab cramps, diarrhea, dysrhythmias, cardia arrest if severe
Hypocalcemianumbness and tingling in extremities and around mouth, + Chvostek's sign, hyperactive reflexes, twitching and cramping, carpal and pedal spasms, tetany, seizures, laryngospasm, dysrhythmias
Hypercalcemiaanorexia, nausea and vomiting, constipation, fatigue, diminished reflexes, - level of consciousness, confusion, personality change, cardia arrest if severe
Hypomagnesemia+ Chvostek's sign, hyperactive deep tendon reflexes, grimacing, dysphagia, tetany, seizures, insomnia, tachycardia, hypertension
Hypermagnesemialethargy, HYPOACTIVE deep tendon reflexes, hypotension, warm feeling, flushing, - rate and depth of rest., cardiac arrest
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Laboratory Findings

Question Answer
Hypokalemia<3.5, U waves, flattened or inverted T waves, ST segment depression
Hyperkalemia>5, peaked T waves, widened QRS, PR prolongation, terminal sine-wave pattern
Hypocalcemia<8.4, prolonged ST segments
Hypercalcemia>10.5, heart block, shortened ST segments
Hypomagnesemia>1.5, prolonged QT interval
Hypermagnesemia<2.5, prolonged PR interval
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