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Nephrology & Urology | Medicine (MD/DO) School Study Aid
Normal Electrolyte Lab Values
- Potassium (K+)
- 3.5 to 5.0 mEq/L
- Calcium (Ca2+)
- 8.5 to 10.5 mg/dL
- Phosphate (PO43–)
- 2.5 to 4.5 mg/dL
- Magnesium (Mg2+)
- 1.5 to 2.5 mEq/L
- Sodium (Na+)
- 135 to 145 mEq/L
- Chloride (Cl–)
- 95 to 105 mEq/L
2 mins
Hypokalemia
- Assessment
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- Interventions
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Nursing Considerations
- Monitor Respiratory Status
3 mins
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Hyponatremia
- Assessment
- < 135 mEq Na+
- Nausea and Vomiting
- Decreased LOC
- Confusion / Lethargy
- Seizures
- Priority Interventions
- Assess Airway
- Reduce Diuretic Dosage
- Fluid Excess Hyponatremia
- Mannitol (Osmitrol)
- Fluid Restriction
- Fluid Deficit Hyponatremia
- Hypertonic Solution (3% or 5% NaCl)
2 mins
Hypernatremia
- Assessment
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Priority Interventions
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
2 mins
Hypocalcemia
- Muscle Spasms
- Assessment
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Considerations
- Oral and IV Replacement of Ca2+
- Seizure Precautions
2 mins
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
2 mins
Hypocalcemia Treatments
- Characteristics
- Treat Underlying Disorder
- Acute Treatments
- IV Calcium Gluconate
- Cardioprotective
- Chronic Treatments
- Calcium Carbonate
- Calcium Citrate
- Vitamin D Supplements
- Considerations
- Treat Hypomagnesemia
2 mins
Hypercalcemia
- Assessment
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- Interventions
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Considerations
- Increased Risk for Renal Calculi
- Increase Fluids
3 mins
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
2 mins
Hypercalcemia Treatments
- Treat Underlying Disorder
- Hydration
- Dialysis
- Calcium Restriction
- Bisphosphonates
- Calcitonin
- Cinacalcet
- Glucocorticosteroids
- Denosumab
2 mins
Hypomagnesemia
- Assessment
- Confusion
- Increased Deep Tendon Reflexes (DTRs)
- Neuromuscular Irritability
- Seizures
- Muscle Cramps
- Tremors
- Insomnia
- Tachycardia
- Interventions
- Magnesium Sulfate
- Foods High in Magnesium
1 min
Hypermagnesemia
- Assessment
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Interventions
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
2 mins
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