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Calcium (Ca2+)
Decreased Values<8.6 mg/dL (serum)
<2.15 mmol/L (ionized)
Symptoms and assessment: Fatigue,
depression, anxiety, neuropathies
(especially of mouth), hyperreflexia, and
tetany. Other symptoms include
Trousseaus sign (contraction of hand upon
blood pressure cuff inflation) and
Chvosteks sign which is a
hyperexcitability of facial muscles when
tapped on face in front of the tragus of the
ear. EKG changes may be present and
include a prolonged QT interval and
possibly ventricular tachycardia.
Sodium (Na+)
Role in Body: Main ECF cation. Maintains
ECF osmolality and pressure. Aids in
generation and transmission of nerve impulses
Potassium (K+)
Role in Body: Potassium is the main cation in the
ICF. It plays an enormous role in establishing cell
membrane potentials and is thus responsible for muscle
contraction including cardiac function. When new
tissues are forming potassium will move into the cells
and when tissues are breaking down potassium will
leave the tissue cells. Potassium balance is maintained
by the sodium potassium pump.
Magnesium (Mg)
Role in Body: Helps metabolize carbs and protein.
Mostly contained in bones. Helps to regulate cardiac
function and directly acts on neuromuscular junction as
an inhibitory cation.
Phosphate (PO43-)
Role in Body: Phosphate is the primary ICF anion. It
is deposited with calcium in bones and is necessary for
RBC production and is an acid/base buffer. The renal
system is the major route for phosphate excretion.
References
Lewis, S.L., Dirksen, S.R. (2011). Medical Surgical Nursing: Assessment and Management of Clinical Problems (8th edition) . St. Louis, MO: Elsevier
Potter, P.A., Perry, A.G., Stockert, P.A., Hall, A.M. (2013). Fundamentals of Nursing (8th edition). St. Louis, MO: Elsevier