Fluid/Electrolyte Imbalances
Calcium Imbalances: 9-11 mg/dl or 4.5-5 mEq/L
Calcium is responsible for excitable tissues (cardiac).
Hypocalcemia
Who: Seen in patients w/ Crohn’s, chronic inflammatory
bowel disease, removal of para/thyroid glands.
Hyperphosphatemia.
S/S: HR changes, decreased BP, mental changes,
hyperactive deep tendon reflexes, d/abd cramping.
Complications: Tetany, laryngospasms, seizures, resp/card
failure.
Tests: Serum CA+, parathyroid hormone increase.
TM: oral for mild, IV for severe.
For patient’s with hyperphosphatemia: aluminum
hydroxide.
Hypercalcemia
Who: Kidney failure, hyperthyroidism, overuse of thiazides,
cancer w/ mets.
S/S: Increased HR/BP, skeletal muscle weakness, decreased
GI motility.
Complications: Urinary stones, resp/cardi failure (muscle
weakness or arrythmias).
TM: Cardiac monitors, saline fluids & promote diuresis are
goals.
Furosemide (calcium excretion) Pamidronate disodium,
zoledronic acid, calcitonin to slow calcium movement from
bones.
Hemodialysis, peritoneal dialysis, or ultrafiltration.
Magnesium Imbalances: 1.5-2.5 mEq/L
Magnesium works w/ Ca for excitable muscle/cardiac tissues.
Hypomagnesemia
Who: Ca imbalances, malnutrition, starvation. Crohn’s/severe
diarrhea (can’t absorb in intestines). Alcoholism
Loop/osmotics, aminoglycosides, anti cancers increase
renal excretion.
S/S: Similar to hypocalcemia
Tests: Chvostek/Trousseau.
Calcium Imbalances: 9-11 mg/dl or 4.5-5 mEq/L
Calcium is responsible for excitable tissues (cardiac).
Hypocalcemia
Who: Seen in patients w/ Crohn’s, chronic inflammatory
bowel disease, removal of para/thyroid glands.
Hyperphosphatemia.
S/S: HR changes, decreased BP, mental changes,
hyperactive deep tendon reflexes, d/abd cramping.
Complications: Tetany, laryngospasms, seizures, resp/card
failure.
Tests: Serum CA+, parathyroid hormone increase.
TM: oral for mild, IV for severe.
For patient’s with hyperphosphatemia: aluminum
hydroxide.
Hypercalcemia
Who: Kidney failure, hyperthyroidism, overuse of thiazides,
cancer w/ mets.
S/S: Increased HR/BP, skeletal muscle weakness, decreased
GI motility.
Complications: Urinary stones, resp/cardi failure (muscle
weakness or arrythmias).
TM: Cardiac monitors, saline fluids & promote diuresis are
goals.
Furosemide (calcium excretion) Pamidronate disodium,
zoledronic acid, calcitonin to slow calcium movement from
bones.
Hemodialysis, peritoneal dialysis, or ultrafiltration.
Magnesium Imbalances: 1.5-2.5 mEq/L
Magnesium works w/ Ca for excitable muscle/cardiac tissues.
Hypomagnesemia
Who: Ca imbalances, malnutrition, starvation. Crohn’s/severe
diarrhea (can’t absorb in intestines). Alcoholism
Loop/osmotics, aminoglycosides, anti cancers increase
renal excretion.
S/S: Similar to hypocalcemia
Tests: Chvostek/Trousseau.
