Fluid and Electrolytes

sodium

135-145

Potassium

3.5-5

Calcium

9-10.5

Phosphate

3-4.5

Magnesium

1.3-2.1

Bicarbonate (HCO3)

22-26

Chloride

98-106

S/S Hypernatremia

SALT: skin flushed,

Agitation,

Low grade fever/Lethargy,

Thirst

S/S Hyponatremia

SALT LOSS: Stupor/Coma,

Anorexia,

Lethargy,

Tendon reflexes,

Limp muscles,

Orthostatic hypotension,

Seizures/headache,

Stomach cramping

S/S Hyperkalemia

MURDER: Muscle Weakness,

Urine Output little/none,

Respiratory Failure,

Decreased cardiac contractility,

Early: muscle twitches/cramps,

Rhythm Changes(Tall T)

S/S Hypokalemia

A SIC WALT ↓  : Alkalosis,

Shallow Respirations,

Irritability,

Confusion/Drowsiness,

Weakness/Fatigue,

Arrhythmia: Tachycardia,

Lethargy,

Thready Pulse,

↓  intestinal motility (NV)

S/S Hypercalcemia

Painful bones, renal stones, abdominal groans, sitting on the throne and psychiatric overtones. seizure, coma. Cardiac: Heart block and V tach.

S/S Hypocalcemia

Trousseau’s and Chvostek’s sign. Laryngeal stridor, dysphagia, tingling in mouth and extremeities. Cardiac: Prolonged QT

Trousseau’s Sign

Involuntary Arm/Wrist contraction when pressure applied. Sign of Hypocalcemia

Chvostek’s sign

Strong face contraction when cheek nerve touched. Sign of Hypocalcemia

S/S Hyperphosphatemia

Tweaking Calcium Can Clear High Phosphate

Tetany

Calcium deposits (in soft tissues)

Convulsions

Cardiac Arrests

Hyperactive neuromuscular reflex

Prolonged QT Interval

S/S Hypophosphatemia

CNS Depression, Rickets and osteomalacia, muscle weakness and pain, respiratory and heart failure

S/S Hypermagnesemia

Lethargy, urinary retention, N/V, impaired reflexes, Paralysis, Respiratory and Cardiac arrest

S/S Hypomagnesemia

Hyperactive deep tendon reflexes, muscle cramps, tremors, seizures, cardiac dysrhythmias, hypocalcemia and hypokalemia

Crystalloids

Used for dehydration and to compensate for fluid loss/imbalance ie NS, D5W, D10W, LR

Colloids

Used to incr blood plasma volume ie Albumin, fresh frozen plasma, blood

Blood Transfusion Rxn

Chills, fever, pruritis, Urticaria

TRALI

Transfusion related acute lung injury

TACO

Transfusion associated circulatory overload