Clinical Electrolytes PDF

Clinical Pearls ▪ Normal values may vary from lab to lab and patient to patient! ▪ Variations can be in: Techniques Age Reagents Gender Weight...

Clinical Pearls ▪ Normal values may vary from lab to lab and patient to patient! ▪ Variations can be in: Techniques Age Reagents Gender Weight Height ▪ Laboratory error is uncommon but can occur ▪ Potential causes: technical error, improper calculation, inadequate specimen, incorrect sampling timing, medication interference ▪ If error is suspected, test should be repeated 4 MEMORIZE Introduction ▪ Usually the first set of labs ordered on initial patient presentation Basic Metabolic Panel (BMP) or Chem-7 Comprehensive Metabolic Panel Sodium (megIt) BMP Potassium (mmol/L) AND Chloride (meal) Albumin (g(d) Carbon dioxide (CO2) (mEq(L) Alkaline phosphatase (ALP) FU international units Glucose (mg/a) Alanine aminotransferase (ALT) i Blood urea nitrogen (BUN) (mg(a)) Aspartate aminotransferase (AST) UlL ↓ units Serum creatinine (mg/d) Total bilirubin (mg(a) Calcium (mg(a) +/- Magnesium and Phosphorus (mg(a)) 6 Sodium + (Na ) ▪ Normal range: 135 – 147 mEq/L (MEMORIZE) ▪ Functions: ▪ Most prevalent cation in extracellular fluid ▪ Important in regulating serum osmolality, fluid balance, and acid-base balance > Normal.4 ; 7 if plt for we are humans : outside This number , we can ▪ Assists in maintaining the electrical compensate with Nat potential necessary for transmission of nerve impulses 8 Clinical Significance > 147 mEq) < 135 mealL Hypernatremia Hyponatremia Increased sodium intake or Decrease in total body sodium increased fluid loss or excess accumulation of o Gastroenteritis, diabetes insipidus, body water 7 too much water dilutes Nat concentration in blood hyperaldosteronism, o Heart failure, _________, chronic cirrhosis __________________________ hypertonic saline renal failure, syndrome of inappropriate antidiuretic hormone secretion (SIADH), severe burns will > not be focused on , just know its a cause of hyponatremia 9 Potassium + (K ) ▪ Normal range: 3.5 – 5 mmol/L (MEMORIZE ▪ Functions: ▪ Main intracellular cation – thus serum concentrations not always the most accurate indicator ▪ Regulation of nerve excitability - aregs that restore/correct heart rhythm (arrythmias) target (t ▪ Acid-base balance ▪ Muscle function ▪ Significant effects on cardiac and neuromuscular function 10 Clinical Significance > 5 mmol/ < 3 5. mmol/L Hyperkalemia Hypokalemia Metabolic or respiratory acidosis, Severe diarrhea/vomiting, renal failure, dehydration respiratory alkalosis, alcohol Medications: ACE and ARB abuse, Cushing disease inhibitors, potassium supplements, Medications: potassium-sparing diuretics, Thiazide/loop/osmotic diuretics, drospirenone containing amphotericin B, insulin, albuterol, contraceptives, Bactrim Lantifungal ____________________ (sulfamethoxazole-trimethoprim) Sodium bicarbonate ↓ WILL BE ASKED ON EXAM ↓ WILL BE ASKED ON EXAM 11 Potassium – Magnesium + to Mga + ~ correlates Clinical Fact : Typically when a , Patient's I is low , we replete Mg' first before giving + supplements. Without Mg2t nothing , to prevent" from leaving (hypokalemia ROMK (renal outer medullary #" channel > closes ROMK to limit * K excretion 12 Chloride - (Cl ) ▪ Normal range: 95 – 105 mEq/L ▪ Functions: ▪ Main ________________ anion extracellular ▪ Passive role in maintenance of fluid balance and acid-base balance 13 Clinical Significance > 105 meal)