Electrolyte Imbalance
| Imbalance | Signs and Symptoms | Common Causes |
|---|---|---|
| Hypercalcemia Serum calcium level >10.5 mg/dL | Weakness, fatigue, anorexia, nausea, vomiting, constipation, polyuria, tingling lips, muscle cramps, confusion, hypoactive bowel tones. | Hyperparathyroidism or malignancies, thiazide diuretics, lithium, renal failure, immobilization, metabolic acidosis. |
| Hypocalcemia Serum calcium level <8.5 mg/dL | Anxiety, irritability, twitching around mouth, convulsions, tingling/ numbness of fingers, diarrhea, abdominal/muscle cramps, arrhythmias. | Inadequate vitamin D intake, low albumin, renal failure, lactose intolerance, Crohn's disease, hyperthyroid, !!UpArrow!! magnesium, acute pancreatitis. |
| Hyperkalemia Serum potassium level >5.0 mEq/L | Weakness, nausea, diarrhea, hyperactive GI, muscle weakness and paralysis, arrhythmias, dizziness, postural hypotension, oliguria. | Potassium-sparing diuretics, NSAIDs, renal failure, multiple transfusions, !!DnArrow!! renal steroids, OD of potassium supplements. |
| Hypokalemia Serum potassium level <3.5 mEq/L | Anorexia, nausea, vomiting, fatigue, !!DnArrow!! LOC, leg cramps, muscle weakness, anxiety, irritability, arrhythmias, postural hypotension, coma. | Anorexia, fad diets, prolonged NPO status, alkalosis, transfusion of frozen RBCs, prolonged NGT suctioning. |
| Hypermagnesemia Serum magnesium level >2.7 mg/dL | Muscle weakness and fatigue are most common, nausea, vomiting, flushed skin, diaphoresis, thirst, arrhythmias, palpitations, dizziness. | !!UpArrow!! Magnesium intake, chronic renal disease, pregnant women on parenteral magnesium for pre-eclampsia, Addison's disease. |
| Hypomagnesemia Serum magnesium level <1.7 mg/dL | Diarrhea, anorexia, arrhythmias, lethargy, muscle weakness, tremors, nausea, dizziness, seizures, irritability, confusion, psychosis, !!DnArrow!! BP, !!UpArrow!! HR. | Prolonged NGT suctioning, diarrhea, laxative abuse, malnutrition, alcoholism, prolonged diuretic use, DKA, digoxin. |
| Hypernatremia Serum sodium level >145 mEq/L | Confusion, fever, tachycardia, low BP, postural hypotension, dehydration, poor skin turgor, dry mucous membranes, flushed. | Fever, vomiting, diarrhea, ventilated Pts, severe burns, profuse sweating, diabetes insipidus, diuresis. |
| Hyponatremia Serum sodium level <135 mEq/L | Nausea, vomiting, abdominal cramps, diarrhea, headache, dizziness, confusion, flat affect, !!DnArrow!! DBP, !!UpArrow!! HR, postural hypotension, !!DnArrow!! deep tendon reflex. | Diuretic use, vomiting, diarrhea, burns, hemorrhage, fever, diaphoresis, CHF, renal failure, hyperglycemia, !!UpArrow!! ADH. |