Electrolytes: functions, levels and symptoms

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1.

Calcium
What is the function of
Calcium in the body?

Calcium functions to:

stabilizes cell membranes
assists in blood clotting
regulates muscle contraction and
relaxation
maintains cardiac function

2.

Calcium
What is the normal serum
level of Calcium?

normal serum level 8.5-10.0

3.

Chloride
What is the normal serum
level?
What is the function?

normal serum level is 98-106

functions in the acid-base
balance
anion
direct relationship with sodium
and potassim
inverse relationship with
bicarbonate

4.

Chvostek and Trousseau's

Sign, causes of:

Hypocalcemia and
hypomagnesemia

8.

Hyperkalemia EKG
changes

Prolonged P R
Wide Q R S
ST segment depression
Tall-tented T-waves

9.

Hyperkalemia symptoms of:

mnemonics:
MURDER the TWAVES

serum level greater than 5.0

---MURDER--M - Muscle weakness
U - urine oliguria/anuria
R - respiratory distress
D - decreased cardiac contractility
E - EKG changes
R - reflexes hyper
---T-WAVES--T - tall tented t-waves
W - weakness in lower extremities;
A - anxiety and irritability
V - v fib and dysrhythmias
E - EKG changes

10.

Hypermagnesemia:
EKG changes

Hypotension
ECG Changes begin at Mg greater
than10
Bradycardia
Prolonged P R
Prolonged Q R S
Prolonged Q T
Complete heart block at 30 mg/dL
Asystole at 34-40 mg/dL

11.

Hypermagnesemia;
symptoms of:
mneumonic
SLOW RENAL

serum level greater than 2.6

---SLOW RENAL--S - slow, shallow respirations
L - lethargy (can lead to coma)
O - out of steam,decreased muscle and
nerve activity
W - weak pulse, decrease cardiac
function can lead to cardiac arrest
R - reflexes decreased
(weakness/paralysis)
E - EKG changes, bradycardia,
hypotension
N - nausea, vomiting
A - appearance is flushed
L - lethargy (drowsiness, can lead to
coma)

Hyperphosphatemia
5.

Hypercalcemia EKG
changes

decreases neuromuscular
irritability,
Shortened Q T
Shortened S T
Widened T wave

6.

Hypercalcemia,
symptoms of:
mneumonics
hydrate HARD or
Moans, Groans, Bones,
Stones and Overtones

serum level greater than10.0

---HARD--H - hypoactive DTR's, weakness,
lethargy
A - abdominal cramping
R - renal stones
D - dysrhythmias (can lead to
cardiac arrest)
---Groans,Moans, Bones, Stones,
and Overtones--Groans - constipation
Moans - pain in joints
Bones - loss of Calcium
Stones - renal stones
Overtones - psychiatric
overtones, depression, confusion

7.

Hyperchloremia;
symptoms of:
mneumonic
take a WALK

serum level greater than106

---WALK--W - weakness
A - active heart (tachycardia,
increased BP)
L - lethargy
K - Kussmaul respirations

12.

Hypernatremia - symptoms of:

mnemonics
TRIP; SALT
FRIED, if dehydrated

tremors, twitching,
hyperreflexia
restlessness
intense thirst
pulmonary and
peripheral edema
skin flushed
agitation
low grade fever
thirst
---if dehydrated--fever, flushed skin
restlessness, agitation
increased fluid
retention
edema
decreased urine output

13.

14.

Hyperphosphatemia - symptoms
of:
mneumonic:
can't DANCE because my
extremities are tingling
CHEMO

Hypocalcemia EKG changes

serum level greater

than 4.5
---DANCE--D - decreased CNS
A - anorexia
N - neuromuscular
irritability
C - Chvostek and
Trousseau's sign
E - extremity tingling
---CHEMO--C - cardiac irregularities
H - hyperreflexia
E - eating poorly
M - muscle weakness
O - oliguria
increases
neuromuscular
irritability
prolonged Q T
prolonged S T

15.

Hypocalcemia sypmtoms of:

mneumonics
TETANY and CATS

serum level less than <8.5

---TETANY--T - twitching in face (Chvostek)
E - EKG changes
T - Trousseau's sign
A - anxiety and confusion
N - numbness (paresthesia)
Y - lar"y"ngeal spasms
---CATS--C - convulsions
A - arrhythmias
T - tetany
S - spasms and stridor

16.

Hypochloremia symptoms of:

mnemonic
get SMART quick

---SMART--S - seizures, coma;

M - muscle cramps;
A - arrhythmias;
R - respiratory arrest;
T - twitching, tetany, hyper DTR's;
Trousseau and Chvostek signs

17.

Hypokalemia EKG
changes

Flattened or inverted T-wave

appearance of U waves
Depressed S T segment

18.

Hypokalemia sypmtoms of:

mnemonic
SUCTION the 6 L's

serum level less than 3.5

---SUCTION--S - skeletal muscle weakness, leg cramps,
lethargy
U -- U-waves
C - constipation
T - toxic effects of digoxin
I - irregular weak pulse
O - orthostatic hypotension
N - numbness (paresthesia)
---6L's--Lethargy, leg cramps, limp muscles, low,
shallow respirations, lethal cardiac
dysthymias

19.

Hypomagnesemia:
EKG changes

Widened Q R S
Prolonged Q T
Decrease T wave
Atrial / ventricular arrhythmias
especially if on digoxin

20.

21.

Hypomagnesemia:
symptoms of:
mneumonics:
STARVED and
IRRITATE

Hyponatremia,
symptoms of:
mnemonic
Tactile and Salt loss,
if dehydrated

serum level less than 1.6

---STARVED--S - seizures
T - tetany
A - anorexia, arrhythmias
R - increased heart rate
V - vomiting
E - emotional labiality
D - DTR's increased
---IRRITATE--I - irritates the CNS-confusion, seizures
R - respiratory muscles labored
R - rapid heart rate
I - irritates the myocardium
T - twitching, tremors, tetany, DTR's
increased
A - anorexia, arrhythmias
T - Trousseau and Chvostek signs
E - EKG changes
tremors, twitching, weakness
abdominal pain
cool, pale skin
skip
tachycardia
lethargy, decreased LOC, confusion
skip
Stupor/coma;
Anorexia
Lethargy, no energy
Tendon reflexes decreased
Limp muscles
Orthostatic hypotension;
Seizures/headache
Stomach cramps

22.

Hypophosphatemia;
symptoms of
mneumonic:
LOW energy and
bone strength

serum level less than 2.6

---LOW--L - lethargy, confusion
O - osteomalacia and rhabdomyolysis
W - weak muscles

23.

Magnesium:
What are the
functions of
magnesium in the
body?

Magnesium is important to
neuromuscular transmission and
cardiac function enzyme reactions,
synthesis of proteins and nucleic acids
A decrease causes neuromuscular
excitability
An increase decreases acetylcholine
release which causes a sedative effect.
Is needed for absorption of potassium

24.

Magnesium
What is the normal
serum level?

normal serum level is 1.6-2.6

25.

Phosphate What is the function of

phosphate in the
body?

phosphate functions:
** is important to the acid-base
balance**
acidosis = less free Calcium; alkalosis
= more ionized Calcium
ATP production
RBC function in O 2 delivery
Neuromuscular function
Metabolism of fats, carbs, and
proteins

26.

Phosphate What is the normal

serum level?

normal serum level is 2.6-4.5

27.

Potassium (K)
What is the normal
serum level?

normal serum level is 3.5-5.0

28.

Potassium
What is the function of
potassium in the
body?

Cardiac and neuromuscular

function
Helps to maintain resting potential

29.

Sodium (Na)
What is the function
of:

Primary regulator of volume,

osmolality and distribution of
extracellular fluid
Involved in Neuromuscular activity

30.

Sodium
What is the normal
serum level?

normal serum level is 135-145

31.

Which electrolytes
have a direct
relationship?

Potassium-Magnesium
Potassium-Calcium
Sodium and Chloride
Potassium and Chloride

32.

Which electrolytes
have an inverse
relationship?

Chloride and Bicarbonate

Sodium and Potassium
Phosphate and Calcium
Phosphate and Magnesium