Fluid & Electrolyte Compare & Contrast
Sodium (Na+) Cation
Functions Sources for Intake
Normal Blood Range
135–145 mEq/L Controls fluid osmolality and volume of blood Salt: Most individuals obtain 90%–94% from
Changes in direct Stimulates conduction of electrical impulses packaged, processed foods, including bacon, ham,
proportion to Cl− along nerves canned vegetables, soy sauce, steak sauces, other
Works with calcium to regulate muscle sauces, salad dressings, processed cheeses,
contraction sandwich meats, salty snacks such as chips, jerky,
pretzels, canned soups, and broths
Adding table salt to prepared foods
Electrolyte Imbalance Signs and Symptom Causative Factors
and Name
Anorexia, nausea, vomiting, headache, GI suctioning, vomiting, diarrhea, ↑ blood sugar,
¯Deficit: hyponatremia lethargy, muscle weakness or twitching,
nonelastic skin turgor, tremors, seizures,
heart failure, renal disease, adrenal insufficiency,
oxytocin (Pitocin), excessive infusion of D5W IV
swelling of optic nerve fluid, disease known as SIADH (syndrome of
inappropriate antidiuretic hormone),
administration of more than one tap-water
enema, excessive diaphoresis
Excess:hypernatremia Thirst, ↑ T, sticky mucous membranes, dry
mouth, flushed skin, lethargy, restlessness,
Diabetes insipidus; heatstroke; watery diarrhea;
ingestion of excessive corticosteroids, sodium
oliguria, ↑ irritability, hallucinations, seizures; chloride, or bicarbonate
pulmonary edema
Chloride (Cl−)
Anion
Functions Sources for Intake
Normal Blood Range
97–107 mEq/L Assists sodium in regulating fluid osmolality High-sodium–content foods listed earlier
Changes in direct and volume Lettuce, tomatoes, celery, olives, seaweed
proportion to sodium Important for acid–base balance
Has inverse relationship Production of gastric HCl
with bicarbonate
Electrolyte Imbalance and Signs and Symptom Causative Factors
Name
Chloride Signs of hypokalemia and metabolic alkalosis: ↓ intake of Cl− or Na+ such as sodium-restricted
¯Deficit:hypochloremia ↑ muscle excitability, tetany, ↓ R, shallow R,
agitation, irritability, seizures, coma
diet; potassium deficiency, excessive diaphoresis,
diarrhea, vomiting, diuretics, gastric suctioning,
heart failure, IV fluids without Cl−, Addison’s
disease, metabolic alkalosis
Excess:hyperchloremia Signs of metabolic acidosis, hyperkalemia, and ↑ Na+ serum level, respiratory alkalosis,
hypernatremia: ↑ R rate and depth, dyspnea, ↑ hyperparathyroidism, severe diarrhea, sodium
P, ↓ cardiac output, arrhythmias, weakness, retention caused by head trauma and ↑
severe edema, ↓ LOC and coma intracranial pressure, renal failure, salicylate
overdose, corticosteroid use, diuretic use,
dehydration, metabolic acidosis
1
Fluid & Electrolyte Compare & Contrast
Potassium (K+)
Cation
Functions Sources for Intake
Normal Blood Range
3.5–5.3 mEq/L 98% in ICF helps regulate fluid balance Dried fruits, tomatoes, potatoes, spinach and other
2% in ECF is important for neuromuscular leafy greens, oranges, bananas, cantaloupe, red
functions, especially for the heart’s contractility meat, chicken, fish, nuts, soy products
and rhythm
Electrolyte Imbalance Signs and Symptom Causative Factors
and Name
Potassium Weak, rapid, or irregular P, ↓ BP, anorexia, Diarrhea; gastric suctioning; vomiting; bulimia;
¯Deficit:hypokalemia nausea, vomiting, ↓ deep tendon reflexes,
fatigue, muscular weakness and cramps,
starvation; diuresis caused by osmotic diuretics;
digoxin toxicity; administration of corticosteroids,
numbness, abdominal distention, ↓ peristalsis, and amphotericin B
ileus; may complain of seeing yellow haloes
around objects if hypokalemia is caused by
digoxin toxicity
Excess:hyperkalemia Bradycardia and other arrhythmias, nausea,
intestinal cramping, diarrhea, anxiety, muscle
Renal failure, ketoacidosis, large burns, excessive
use of K+-sparing diuretics, too-rapid IV
weakness, numbness or prickly sensations, administration of K+, severe dehydration
flaccid paralysis Safety: Both severe deficit or excess can result in
life-threatening arrhythmias.
Magnesium (Mg2+)
Cation
Functions Sources for Intake
Normal Blood Range
1.6 –2.2 mg/dL Assists neuromuscular function; dilation of Leafy green vegetables, whole grains, beans, fish
arteries and arterioles; enzyme function; (halibut), almonds, soybeans
carbohydrate and protein metabolism
Electrolyte Imbalance and Signs and Symptom Causative Factors
Name
Magnesium Vomiting, anorexia, insomnia, arrhythmias, Starvation, malabsorption disorders,
¯Deficit:hypomagnesemia mood swings and hyperirritability, dizziness,
↑ neuromuscular irritability, muscle
ketoacidosis, alcoholism and alcohol
withdrawal, administration of gentamicin,
weakness and tremors, positive Chvostek’s hyperparathyroidism, vomiting
and Trousseau’s signs
Excess:hypermagnesemia ↓ BP, ↑ P, ↓ R, hypoactive reflexes, muscle
weakness and paralysis, drowsiness,
Late renal failure, adrenal insufficiency,
excessive administration of IV Mg2+ or oral
lethargy, flushing, diaphoresis, cardiac antacids
arrest, death
2
Fluid & Electrolyte Compare & Contrast
Calcium (Ca2+)
Cation
Functions Sources for Intake
Normal Blood Range
Total Ca2+: Strengthens skeletal bones and teeth Dairy products, green vegetables, shellfish,
8.2–10.2 mg/dL Ionized Ca2+: stimulates conduction of electrical salmon, dried beans
Ionized Ca2+: impulses via nerves, which controls muscle
4.64–5.28 mg/dL contraction and relaxation, includes heart
muscle
Initiates enzyme action
Cellular membrane permeability
Electrolyte Imbalance Signs and Symptom Causative Factors
and Name
Calcium Muscle cramps and tremors; tetany; ↓ BP; Inadequate vitamin D consumption,
¯Deficit:hypocalcemia tingling or numbness of fingers, toes, around
the mouth; bronchospasm; carpopedal spasms;
malabsorption disorders, pancreatitis, peritonitis,
alkalosis, hypothyroidism or hypoparathyroidism
↑ deep tendon reflexes; prolonged QT interval
on ECG; positive Chvostek’s and Trousseau’s
signs
Excess:hypercalcemia Severe constipation, anorexia, nausea,
vomiting, polydipsia, lethargy, fatigue,
Prolonged bedrest, excessive ingestion of calcium
or vitamin D supplements, excessive serum level
headache, polyuria, ↓ deep tendon reflexes, of digoxin, cancer, metabolic acidosis
muscular weakness, bone fractures without
trauma, confusion, slurred speech, psychosis,
ileus development
Phosphorus (PO43–)
Anion
Functions Sources for Intake
Normal Blood Range
2.5–4.5 mg/dL Vital for all tissues; muscle and red blood cell Meats, fish, egg yolks, dairy products, nuts,
May be higher in children functions; metabolism of fat, protein, beans, legumes, whole grains, soft drinks
carbohydrates; manufacturing ATP energy
source
Electrolyte Imbalance and Signs and Symptom Causative Factors
Name
Phosphorus Muscle weakness, bone pain, paresthesia of ↓ K+ or ↓ Mg2+ serum level, vomiting, diarrhea,
¯Deficit:hypophosphatemia extremities and around the mouth,
stuttering, chest pain, confusion, irregular P,
hyperventilation, burns, hyperparathyroidism,
bone disease, diabetic ketoacidosis, alcoholism
↑ susceptibility to infection, respiratory and alcohol withdrawal, bowel disorders, poor
failure dietary intake
Excess:hyperphosphatemia
↑ P, tetany, anorexia, nausea, tingling of Renal failure, excessive intake of vitamin D or
fingers and toes, irritability, carpopedal phosphorus, fluid volume depletion,
spasms, ↑ deep tendon reflexes, muscle conditions causing breakdown of large
twitching, tetany, seizures, ↓ cardiac output, amounts of tissue
coma
