Digital Electrolyte Imbalances Study Guide for Nurses PDF

Study Guide For Nurses  INDEX Overview What Do Electrolytes Do? Causes Symptoms Types of Electrolyte Imbalance Treatment Risk Factors Diagnosis Dehydration Functions Of Electrolytes 5 Incredible Electrolytes & its Functions Electrolyte Deficiencies And How To Treat Them? F...

Study Guide For Nurses  INDEX Overview What Do Electrolytes Do? Causes Symptoms Types of Electrolyte Imbalance Treatment Risk Factors Diagnosis Dehydration Functions Of Electrolytes 5 Incredible Electrolytes & its Functions Electrolyte Deficiencies And How To Treat Them? FAMZ NURSING NOTES  overview An electrolyte imbalance occurs when you have too much or not enough of certain minerals in your body. This imbalance may be a sign of a problem like kidney disease. Electrolytes are minerals that give off an electrical charge when they dissolve in fluids like blood and urine. Your body makes electrolytes. You also get these minerals from foods, drinks and supplements. Electrolytes in blood, tissue, urine and other body fluids play a critical role in balancing body fluids, regulating your heart rhythm and supporting nerve and muscle function. What do electrolytes do? Electrolytes are electrically charged minerals dissolved within the body fluids that, when exchanged properly in and out of the cells, preserve the body’s nerve and muscle functions. There are different types of electrolytes; sodium, potassium, and chloride play a significant role in cell homeostasis (i.e., a self-regulating process of the body to adjust to conditions that are optimal for survival), along with calcium, magnesium, phosphate, and bicarbonate. Electrolytes perform different functions in your body: Sodium controls fluid levels and aids nerve and muscle function. Potassium supports heart, nerve and muscle functions. It also moves nutrients into cells and waste products out of them while supporting your metabolism. Calcium helps blood vessels contract and expand to stabilize blood pressure. It also secretes hormones and enzymes (proteins) that help the nervous system send messages.  Chloride helps maintain healthy blood levels, blood pressure and body fluids. Magnesium aids nerve and muscle function. It also promotes the growth of healthy bones and teeth. Phosphate supports the skeletal system, as well as nerve and muscle function. Bicarbonate helps balance acids and basic alkaline compounds (bases) in blood (pH balance). Bicarbonate also helps move carbon dioxide (a waste product) through your bloodstream. What causes electrolyte imbalances? Electrolyte imbalances are caused by different conditions and medications that intervene with the body’s natural fluid balance. Sodium Hyponatremia is considered the most common electrolyte imbalance. It can be caused by the decrease of the circulating blood volume, as seen in congestive heart failure and hepatic cirrhosis. Additionally, disorders leading to high antidiuretic hormone (ADH) levels, like syndrome of inappropriate ADH secretion (SIADH), adrenal insufficiency, and hypothyroidism can also cause hyponatremia. Primary polydipsia (i.e., excessive water intake), low dietary sodium intake causing an increase in blood volume, hyperglycemia, and dyslipidemia are all causes of hyponatremia.  Potassium Hypokalemia is usually caused by low dietary intake or unreplaced fluid loss from the GI tract and urine and can be seen after excessive vomiting and loop diuretic use, respectively. Hyperkalemia can be noted in metabolic acidosis states - this is due to extensive potassium release from cells - but can also be noted in insulin deficiency, diabetic ketoacidosis, beta-blocker use, or following cell death in chemotherapy, where intracellular stores are released. Decreased potassium excretion from the kidneys (e.g. in acute or chronic kidney disease), aldosterone deficiency, or aldosterone resistance can also cause increased potassium levels. Chloride Hypochloremia is mostly encountered after great GI fluid losses, as well as in renal fluid losses with diuretics. Hyperchloremia can occur when fluid losses exceed chloride losses; when the body’s ability to manage excessive chloride is disrupted; or when the bicarbonate serum levels are low and chloride levels are high. Normal anion gap metabolic acidosis or respiratory alkalosis may be present with low bicarbonate levels and hyperchloremia. Bicarbonates Bicarbonate levels shift in acid-base disturbances. There is an increase in bicarbonate levels in primary metabolic alkalosis and it acts as compensation in primary respiratory acidosis. Bicarbonate falls in both primary metabolic acidosis and also decreases in response to primary respiratory alkalosis.  Calcium Hypocalcemia can be caused by hypoparathyroidism, typically seen post- surgery after thyroidectomy (i.e., after thyroid removal) due to frequent accidental damage due to their proximity to the thyroid. Hypocalcemia can also be noted in severe vitamin D deficiency, due to malnutrition or malabsorption. Magnesium Hypomagnesemia can be seen after renal or GI fluid losses, and more rarely in individuals who consume excessive amounts of alcohol. Hypermagnesemia can occur after increased magnesium intake, either orally (e.g., after use of magnesium-containing medications such as antacids and laxatives) or more commonly through intravenous access. Phosphate Low levels of phosphate in the blood can be seen in individuals with vitamin D deficiency, hyperparathyroidism, and refeeding syndrome, which is a potentially fatal condition that causes unexpected shifts of fluids and electrolytes in malnourished individuals following re- introduction of food. Hyperphosphatemia, on the other hand, can be caused by hypoparathyroidism and chronic kidney disease.  SYMPTOMS Electrolyte imbalances have a very broad range of signs and symptoms, from being completely asymptomatic to having fatal arrhythmias. The coexistence of one or more electrolyte imbalances in individuals with mixed medical conditions can create a complex clinical presentation. However, typically, each electrolyte imbalance presents with signs and symptoms that are more indicative of the specific imbalance. Symptoms of an electrolyte imbalance vary depending on the severity and electrolyte type. A slight electrolyte imbalance may not cause noticeable changes. When problems occur, you may experience: Confusion and irritability. Diarrhea or constipation. Fatigue. Headaches. Irregular or fast heart rate (arrhythmia). Muscle cramps, muscle spasms or weakness. Nausea and vomiting. Numbness or tingling in limbs, fingers and toes. Any imbalance of phosphate levels usually causes muscle cramping, weakening, and numbness, and can also affect bone density, resulting in softened or weakened bones. Bicarbonate disturbances often present with headaches, fatigue, and any other symptoms related to the underlying acid-base disturbance. Imbalances of chloride are mostly asymptomatic. In cases of extremely high or extremely low levels of chloride, vague symptoms, such as confusion or swelling, may be noticed.  Types of electrolyte imbalance Elevated levels of an electrolyte are indicated with the prefix “hyper-.” Depleted levels of an electrolyte are indicated with “hypo-.” Conditions caused by electrolyte level imbalances include: Calcium: hypercalcemia and hypocalcemia Chloride: hyperchloremia and hypochloremia Magnesium: hypermagnesemia and hypomagnesemia Phosphate: hyperphosphatemia or hypophosphatemia Potassium: hyperkalemia and hypokalemia Sodium: hypernatremia and hyponatremia Calcium Calcium is a vital mineral that your body uses to stabilize blood pressure and control skeletal muscle contraction. It’s also used to build strong bones and teeth. Hypercalcemia occurs when you have too much calcium in the blood. This is usually caused by the following: kidney disease hyperparathyroidism lung diseases, such as tuberculosis or sarcoidosis certain types of cancer, including lung and breast cancers Hypocalcemia occurs due to a lack of adequate calcium in the bloodstream. Causes can include: kidney failure hypoparathyroidism vitamin D deficiency pancreatitis Chloride Chloride is necessary for maintaining the proper balance of bodily fluids. It can happen as a result of the following: severe dehydration kidney failure metabolic acidosis Hypochloremia develops when there’s too little chloride in the body. Causes include: Other causes can include: metabolic alkalosis diuretics chronic respiratory acidosis extreme fluid loss such as from vomiting or diarrhea Magnesium Magnesium is a critical mineral that regulates many important functions, such as: muscle contraction heart rhythm nerve function Hypomagnesemia means having too little magnesium in the body. Common causes include: alcohol use disorder malnutrition malabsorption diarrhea Phosphate The kidneys, bones, and intestines balance phosphate levels in the body. Phosphate is necessary for various functions and interacts closely with calcium. Hyperphosphatemia can occur due to the following: chronic kidney disease severe breathing difficulties underactive parathyroid glands severe muscle injury Low levels of phosphate, or hypophosphatemia, can be seen in: acute alcohol abuse severe burns refeeding syndrome vitamin D deficiency  Potassium Potassium is particularly important for regulating heart function. It also helps maintain healthy nerves and muscles. Hyperkalemia may develop due to high levels of potassium. This condition can be fatal if left undiagnosed and untreated. It’s typically triggered by: severe dehydration kidney failure severe acidosis, including diabetic ketoacidosis certain medications, including some blood pressure medications and diuretics Hypokalemia occurs when potassium levels are too low. This happens as a result of the following: eating disorders severe vomiting or diarrhea certain medications, including laxatives, diuretics, and corticosteroids Sodium Sodium is necessary for the body to maintain fluid balance and is critical for appropriate body function. It also helps to regulate nerve function and muscle contraction. Hypernatremia occurs when there’s too much sodium in the blood. Abnormally high levels of sodium are often caused by severe dehydration, which can be caused by: inadequate water consumption excessive loss of bodily fluids as a result of prolonged vomiting, diarrhea, or sweating Hyponatremia develops when there’s too little sodium. Common causes of low sodium levels include: vomiting or diarrhea poor nutrition alcohol use disorder overhydration thyroid or adrenal disorders liver, heart, or kidney failure  Treating electrolyte imbalance Treatment varies depending on the type of electrolyte imbalance and the underlying condition causing it. Certain treatments are generally used to restore the proper balance of minerals in the body. These include: Intravenous (IV) Fluids Intravenous (IV) fluids, typically containing sodium chloride, can help rehydrate the body. This treatment is commonly used in cases of dehydration resulting from vomiting or diarrhea. Electrolyte supplements can be added to IV fluids to correct deficiencies. Certain IV Medications IV medications can help your body restore electrolyte balance quickly. They can also protect you from negative effects while being treated by another method. The medication you receive will depend on the electrolyte imbalance you have. Medications that may be administered include calcium gluconate, magnesium sulfate, and potassium chloride. Oral Medications and Supplements Oral medications and supplements are often used to correct chronic mineral abnormalities in your body. This is more common if you’ve been diagnosed with ongoing kidney disease. Depending on your electrolyte imbalance, you may receive medications or supplements such as: calcium (gluconate, carbonate, citrate, or lactate) magnesium oxide potassium chloride Hemodialysis Hemodialysis is a type of dialysis that uses a machine to remove waste from your blood. One way to get the blood to flow to this artificial kidney is for your doctor to surgically create a vascular access, or an entrance point, into your blood vessels. This entrance point will allow a larger amount of blood to flow through your body during hemodialysis treatment. This means more blood can be filtered and purified.  risk factors Infants, young children and older adults are more prone to changes in electrolyte levels, but an imbalance can happen to anyone. Certain conditions can also throw off your body’s electrolyte levels. You may be more likely to develop an electrolyte imbalance if you have: Burns. Cancer. Cardiovascular disease, heart failure or high blood pressure. Dehydration due to not drinking enough liquids or from excessive vomiting, diarrhea, sweating (hyperhidrosis) or fever. Overhydration or water intoxication (drinking too much water). Eating disorders. Kidney disease. Liver disease like cirrhosis. Substance use disorder. Certain medications can also affect electrolyte levels. These include: Antibiotics. Chemotherapy drugs. Corticosteroids. Diuretics and laxatives.  risk factors Medications Certain medications can cause electrolyte imbalances by altering the balance of fluids and electrolytes in the body. Diuretics, for example, can increase urine output, leading to a decrease in electrolyte levels. Laxatives can cause fluid loss, which can also result in electrolyte imbalances. Corticosteroids, which are often used to treat inflammation, can interfere with the body's ability to regulate electrolytes. Dehydration Dehydration occurs when the body loses more fluid than it takes in. This can happen due to insufficient fluid intake, excessive sweating, or certain medical conditions. When the body is dehydrated, electrolyte levels can become imbalanced. This is particularly true for sodium and potassium, which are important electrolytes involved in fluid balance. Chronic Kidney Disease The kidneys play a critical role in regulating electrolyte levels by filtering the blood and removing excess electrolytes. When the kidneys are not functioning properly, electrolyte levels can become imbalanced. This is a common complication of chronic kidney disease. Alcoholism Alcohol can cause electrolyte imbalances by increasing urine output and altering the balance of fluids and electrolytes in the body. Excessive alcohol consumption can also interfere with the body's ability to absorb and retain nutrients, leading to malnutrition and electrolyte imbalances.  risk factors Eating Disorders People with eating disorders such as anorexia nervosa or bulimia nervosa are at risk for electrolyte imbalances due to malnutrition and dehydration. These conditions can cause a loss of electrolytes, particularly potassium and magnesium, which are essential for proper muscle and nerve function. Vomiting and Diarrhea Vomiting and diarrhea can cause a loss of fluids and electrolytes, leading to dehydration and electrolyte imbalances. This is particularly true for sodium and potassium, which are important electrolytes involved in fluid balance. Hormonal Imbalances Certain hormonal imbalances, such as those associated with Addison's disease or Cushing's syndrome, can disrupt electrolyte balance. These conditions affect the adrenal glands, which produce hormones involved in electrolyte regulation. Chronic Illnesses Chronic illnesses such as diabetes or congestive heart failure can affect the body's ability to regulate electrolytes. For example, people with diabetes may experience electrolyte imbalances due to high blood sugar levels, while people with congestive heart failure may experience electrolyte imbalances due to fluid buildup in the body. Excessive Sweating Athletes and people who work in hot environments may experience electrolyte imbalances due to excessive sweating. This is because sweating causes a loss of fluids and electrolytes, particularly sodium and potassium.  fUNCTIONS OF ELECTROLYTES Your cells use electrolytes to conduct electrical charges, which is how your muscles contract. Those same electrical charges also help with chemical reactions, especially when it comes to hydration and the balance of fluids inside and outside of cells. The key principle that electrolytes rely on is that certain chemical elements can naturally hold a positive or a negative electrical charge. When those elements are dissolved in a liquid, that liquid can then conduct electricity. Electrolytes are crucial to keeping your nervous system and muscles functioning and your internal environment balanced. Nervous System Function Your brain sends electrical signals through your nerve cells to communicate with the cells throughout your body. These signals are called nervous impulses, and they’re generated by changes to the electrical charge of the nerve cell membrane. The changes occur due to the movement of the electrolyte sodium across the nerve cell membrane. When this happens, it sets off a chain reaction, moving more sodium ions (and the change in charge) along the length of the nerve cell axon. Muscle Function The electrolyte calcium is needed for muscle contraction. It allows muscle fibers to slide together and move over each other as the muscle shortens and contracts. Magnesium is also required in this process so that the muscle fibers can slide outward and muscles can relax after contraction.  fUNCTIONS OF ELECTROLYTES Proper Hydration Water must be kept in the right amounts both inside and outside each cell in your body. Electrolytes, particularly sodium, help maintain fluid balance through osmosis. Osmosis is a process where water moves through the wall of a cell membrane from a dilute solution (more water and fewer electrolytes) toward a more concentrated solution (less water and more electrolytes). This prevents cells from bursting from being too full or shriveling up due to dehydration. Internal pH Levels To stay healthy, your body needs to regulate its internal pH. pH is a measure of how acidic or alkaline a solution is. In your body, it’s regulated by chemical buffers, or weak acids and bases, which help minimize changes in your internal environment. For example, your blood is regulated to stay at a pH of around 7.35 to 7.45. If it deviates from this, your body can’t function properly, and you become unwell. Having the right balance of electrolytes is fundamental to maintaining your blood pH level. At the most basic chemical level, electrolytes help your body maintain balance. Just like electricity uses ions to travel from place to place in salt water, your body uses ions to transport chemical compounds in and out of cells. Diagnosing electrolyte imbalance A simple blood test can measure the levels of electrolytes in your body. A blood test that looks at your kidney function is important as well. Your doctor may want to perform a physical exam or order extra tests to confirm a suspected electrolyte imbalance. These additional tests will vary depending on the condition in question. For example, hypernatremia (too much sodium) can cause skin elasticity loss due to significant dehydration. Your doctor can perform a pinch test to determine whether dehydration affects you. An electrocardiogram (ECG or EKG), an electrical tracing of your heart, may also be useful to check for any irregular heartbeats, rhythms, or ECG or EKG changes brought on by electrolyte problems. An electrolyte panel is a blood test that measures electrolyte levels. Healthcare providers often order an electrolyte panel if you: Need blood tests for a routine physical exam. Are in the hospital. Have certain health conditions. Experience disease symptoms. Your provider may also order a basic metabolic panel or comprehensive metabolic panel. These blood tests check for electrolytes, as well as other substances in blood. Measurement of electrolyte levels in the blood, available through a comprehensive metabolic panel blood test, is also necessary for diagnosis confirmation. An arterial blood gas (ABG) test may also be ordered to determine the acid-base status. Mixed electrolyte, acid-base, and fluid disturbances occur frequently and can be challenging to diagnose due to their complex clinical presentation.  dehydration Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don't drink enough water during hot weather — especially if you are exercising vigorously. Dehydration is a condition in which you lose so much body fluid that your body can’t function normally. It occurs when you lose more fluids than you take in. Dehydration may happen on a particularly hot day if you sweat a lot, or if you’re sick with fever, diarrhea or vomiting. It can also occur if don’t drink enough water, or if you’re taking a medication that increases your pee (urine) output.  Symptoms Thirst isn't always a reliable early indicator of the body's need for water. Many people, particularly older adults, don't feel thirsty until they're already dehydrated. That's why it's important to increase water intake during hot weather or when you're ill. The signs and symptoms of dehydration also may differ by age. Infant or Young Child Dry mouth and tongue No tears when crying No wet diapers for three hours Sunken eyes, cheeks Sunken soft spot on top of skull Listlessness or irritability Adult Extreme thirst Less frequent urination Dark-colored urine Fatigue Dizziness Confusion Risk factors Anyone can become dehydrated, but certain people are at greater risk: Infants and Children: The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. People with Chronic Illnesses: Having uncontrolled or untreated diabetes puts you at high risk of dehydration. People who work or exercise outside: When it's hot and humid, your risk of dehydration and heat illness increases. Older Adults: As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute.  levels of dehydration Healthcare providers categorize dehydration as: Mild: You just have to take in more fluids orally (by mouth). Drink water, but replace fluids with a drink that contains electrolytes if you experience significant sweating or fluid loss from vomiting and diarrhea. You should feel better after five or 10 minutes. Moderate: Moderate dehydration requires an IV (hydration through your vein). You’ll get this in an urgent care, emergency room or hospital. Severe: See a healthcare provider if your symptoms of dehydration are severe. Call 911, your local emergency services number or go to an emergency room. Treatment The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause. For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water.  5 INCREDIBLE ELECTROLYTES & ITS FUNCTIONS Calcium Calcium plays an optimal role in muscle contractions, nerve signaling and bone formation. Sodium Sodium helps in maintaining the fluid balance, muscles and nerve functions. Chloride Chloride is the chief anion in the body which helps to maintain the fluid and acid Potassium balance. Potassium is crucial for controlling blood pressure, regulating heart functions and preventing strokes. Magnesium Magnesium is needed for proper heartbeat, nerve and muscle functions and stronger bones.  electrolyte deficiencies and how to treat them? When you are trying to lose weight on a special eating plan you can have deficiencies that occur due to rapid weight loss. The loss of water can also cause electrolyte loss. Here are 4 main electrolytes and their symptoms, debugged. Electrolytes Symptoms Treatment Cramp in leg or feet Eat Dairy Irritability and If you take calcium twitching supplements, take Low Calcium Chronic cough or with K2 and D3 so it depression can be absorbed Can’t sleep Never take calcium carbonate Weak muscles Eat Leafy Greens Low Hyperirritability Take a magnesium Magnesium supplement Fatigue Eat potassium rich Low Cramps veggies Potassium Constipation Take potassium Nausea supplement K3 Sugar Craving Headache Add sea salt only Low Sodium Fatigue need 1 to 1 1/2 table Appetite Loss spoon. Nausea Fuzzy Thinking