Clinical Manifestations: A Case Study
Electrolyte | Hypo | Cause | Clinical Manifestations | Hyper | Cause | Clinical Manifestations | Sodium (Na+) | <125 meq/L | * Inadequate intake * Hypoaldesteronism * Excessive diuretic therapy * Furosemide * Ethacrinic acid * Thiazides | * Extracellular volume contraction and hypovolemia (but may not if water excess) * Increased intracellular water; edema * Brain cell swelling, irritability, depression, confusion * Systemic cellular edema, including weakness, anorexia nausea, and diarrhea * Edema | >155 meq/L | * Excessive hypertonic salt solutions * IV hypertonic sodium * Saline-induced abortions * Selected infant formulas * Hyperaldosteronism * Cushing syndrome | Hypervolemia: * Weight gain * binding pulse * increased BP * edema * venous distentionNeuromuscular: * muscle weakness * seizuresIntracellular dehydration * thirst * fever * decreased urine output * shrinkage of brain cells * confusion * coma * cerebral hemorrhage | Potassium (K+) | <3.0 meq/L | * ECF hypokalemia * Gastrointestinal and renal disorders * Diarrhea * Vomiting * Diuretic use | * Carbohydrate metabolism * Decrease ablility to urinate * Neuromuscular and cardiac effects * Weak skeletal muscles * Smooth muscle atony * Cardiac dysrhythmias |
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Calcium (Ca+) | <6.5 mg/dL | * inadequate intestinal absorption * deposition of ionized Ca into bone of soft tissue * blood administration or decrease in PTH and vit D | * neuromuscular excitability * confusion * paresthesias around the mouth and in the digits * carpopedal spasm * hyperreflexia * Chvostek sign and Trousseau sign | >13.5 mg/dL | * caused by disease: hyperparathyroidism * bone metastases with Ca resorption * excess vitamin D * tumor produce PTH and elevate Ca * acidosis | * fatigue, weakness * lethargy * anorexia * nausea * constipation * impaired renal function * kidney stones
Calcium (Ca+) | <6.5 mg/dL | * inadequate intestinal absorption * deposition of ionized Ca into bone of soft tissue * blood administration or decrease in PTH and vit D | * neuromuscular excitability * confusion * paresthesias around the mouth and in the digits * carpopedal spasm * hyperreflexia * Chvostek sign and Trousseau sign | >13.5 mg/dL | * caused by disease: hyperparathyroidism * bone metastases with Ca resorption * excess vitamin D * tumor produce PTH and elevate Ca * acidosis | * fatigue, weakness * lethargy * anorexia * nausea * constipation * impaired renal function * kidney stones