Electrolyte Imbalances Overview

Electrolyte Imbalances

• Hypovolemic Hyponatremia:
  • Renal causes: adrenal insufficiency, osmotic diuresis, diuretic use
  • Non-renal causes: excessive sweating (diaphoresis), vomiting (V/D)
  • Characterized by low sodium levels in the blood due to lower total body water.
• Hypervolemic Hyponatremia:
  • Sodium diluted in excess water
• Hypernatremia:
  • Excess sodium in the bloodstream or decreased body water.
  • Most common cause: decreased body water.
• Hypokalemia:
  • Caused by diuretics, renal stress, metabolic alkalosis, high aldosterone levels, vomiting, diarrhea.
  • Low potassium levels in the blood.
• Hyperkalemia:
  • Main cause: kidney failure.
  • High potassium levels in the blood.
• Hypocalcemia:
  • Low calcium levels in the blood due to insufficient calcium in diet, vitamin D deficiency, or kidney disease.
• Hypercalcemia:
  • High calcium levels in blood caused by elevated PTH hormone, which removes calcium from bones and puts it into the blood, or cancer as a cause of bone destruction.
• Hypophosphatemia:
  • Low phosphorus; caused by decreased intestinal absorption or increased excretion by kidneys.
• Hyperphosphatemia:
  • High phosphorus; caused primarily by kidney failure.
• Hypomagnesemia:
  • Low magnesium levels due to sepsis, burns, laxative abuse, diarrhea, increased renal excretion, and wounds.
• Hypermagnesemia:
  • High magnesium levels due to kidney dysfunction.

Complications of Electrolyte Imbalances

• Hypovolemic Hyponatremia can cause confusion, behavioral changes (common in elderly), and increased risk of falls.
• Hypervolemic Hyponatremia can result in fluid shifting from the extracellular fluid (ECF) to the intracellular fluid (ICF) causing cell swelling, potentially brain swelling leading to seizures or coma.
• Hypernatremia leads to cell dehydration and shrinkage, impacting neuron function and cell responsiveness.
• Hypokalemia can cause cardiac dysrhythmias, cardiac issues, and muscle weakness/cramps.
• Hyperkalemia results in bradycardia, dysrhythmias, and potentially cardiac arrest.
• Hypocalcemia leads to bone pain and fragility.
• Hypercalcemia can cause kidney failure, kidney stones, nervous system issues, and bone problems.
• Hypophosphatemia and Hyperphosphatemia lead to bone-related issues.
• Hypomagnesemia can cause long-term cardiovascular disease, diabetes, osteoporosis.
• Hypermagnesemia results in cardiovascular disease, low blood pressure, and arrhythmias, confusion, and lethargy.

Signs and Symptoms of Electrolyte Imbalances

• Specific symptoms for each imbalance are provided in the notes, including those related to the amount of fluid in the body.