Electrolyte Imbalances

Electrolyte Imbalances
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 the mouth, convulsions, tingling/numbness of fingers, diarrhea, abdominal/muscle cramps, arrhythmias.	Low albumin level is most common, renal failure, hyperthyroid, ↑magnesium, acute pancreatitis, Crohn’s disease.
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, ↓renal steroids, OD of potassium supplements.
Hypokalemia Serum potassium level <3.5 mEq/L	Anorexia, nausea, vomiting, fatigue, ↓ 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.	↑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, ↓ BP, ↑ HR.	Prolonged NGT suctioning, diarrhea, laxative abuse, malnutrition, alcoholism, prolonged diuretic use, DKA, digoxin.
Hypernatremia Serum sodium level >145 mEq/L	Confusion if severe, fever, tachycardia, low BP, postural hypotension, dehydration, poor skin turgor, dry mucous membranes/ tongue, 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, ↓DBP, ↑HR, postural hypotension, ↓deep tendon reflex.	Diuretic use, vomiting, diarrhea, burns, hemorrhage, fever, diaphoresis, CHF, renal failure, hyperglycemia, ↑ADH.