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Box 02-3

Use the quick-reference chart below to interpret serum electrolyte test results in adult patients. This chart also lists disorders that can cause imbalances. Note: Always check your facility's norms, as they may differ slightly.

ElectrolyteResultsImplicationsCommon causes
Serum sodium135 to 145 mEq/LNormal
<135 mEq/LHyponatremiaSyndrome of inappropriate antidiuretic hormone secretion
>145 mEq/LHypernatremiaDiabetes insipidus, diabetes mellitus, fluid loss, vomiting, and diarrhea
Serum potassium3.5 to 5 mEq/LNormal
<3.5 mEq/LHypokalemiaDiarrhea, vomiting, diuretic therapy, excessive sweating, refeeding syndrome
>5 mEq/LHyperkalemiaBurns, kidney failure, and response to injury
Total serum calcium8.9 to 10.1 mg/dlNormal
>8.9 mg/dlHypocalcemiaAcute pancreatitis
>10.1 mg/dlHypercalcemiaHyperparathyroidism
Ionized calcium4.4 to 5.3 mg/dlNormal
<4.4 mg/dlHypocalcemiaMassive transfusion
>5.3 mg/dlHypercalcemiaAcidosis
Serum phosphates2.5 to 4.5 mg/dl or 1.8 to 2.6 mEq/LNormal
>2.5 mg/dl or 1.8 mEq/LHypophosphatemiaDiabetic ketoacidosis
<4.5 mg/dl or 2.6 mEq/LHyperphosphatemiaRenal insufficiency
Serum magnesium1.5 to 2.5 mEq/LNormal
<1.5 mEq/LHypomagnesemiaMalnutrition, chronic diarrhea
>2.5 mEq/LHypermagnesemiaKidney failure
Serum chloride98 to 108 mEq/LNormal
<98 mEq/LHypochloremiaProlonged vomiting or gastric aspiration
>108 mEq/LHyperchloremiaHypernatremia