Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)

Electrolyte Imbalances

Definition/Etiology:

• Common Electrolytes Functions
  • Cations:
    • Sodium- fluid, nerve, muscles
    • Potassium- heart, muscles
    • Calcium- blood vessels contract (BP), nervous system send messages
    • Magnesium- nerve, muscles
  • Anions:
    • Chloride- BP and fluid levels
    • Phosphorus- bones, nerve, muscles
    • Bicarbonate- acid/base balance; “base”

Pathophysiology:

• Function of Electrolytes (hyper- vs. hypo- table)
  • Sodium
  • Potassium
  • Calcium
  • Chloride
  • Magnesium
  • Phosphorus
  • Bicarbonate

Noticing: Assessment & Recognizing Cues:

• Risk Factors for Electrolyte Imbalances
  • Conditions
    • Kidney disease
    • Cirrhosis
    • Hydration imbalance (dehydration or overhydration)
    • CV disease
    • Burns
    • Cancer
    • Eating disorders
  • Medications
    • Antibiotics
    • Chemotherapy
    • Corticosteroids 
    • Substance abuse

Interpreting: Analyzing & Planning:

• Symptoms
  • Confusion
  • Bowel dysfunction
  • Fatigue or irritability
  • Headaches
  • Arrhythmias
  • Muscle dysfunction or weakness
  • Nausea/vomiting
  • Numbness in extremities

Responding: Patient Interventions & Taking Action:

• Diagnosis and Management
  • Diagnosis
    • Complete metabolic Panel (CMP)
    • Identify cause
  • Treatment
    • Correct the imbalance/cause
    • IV fluids
    • Monitor kidney function
    • Start hemodialysis if needed

Reflecting: Evaluating Patient Outcomes:

• Prevention
  • Prevent Complications
    • Coma
    • Seizures
    • Cardiac arrest
• Long-term management
  • Prevent reoccurrence
  • Adequate hydrate

Linchpins (Key Points):

• Back to balance
  • Too much or too little; it’s all about balance
• Cations = Na, K, Ca Mg
• Anions = Cl, Ph, HCO3
• Treatment= fix cause/imbalance, IV fluids
• Prevent= complications, reoccurrence