ELECTROLYTE BALANCE

                         ELECTROLYTE BALANCE

Electrolytes are minarals in our body that have an electric charge. They arr in oi uto body, urine, and body fluid. Maintaining the proper balance of electrolytes help in our body's blood chemistry,musicak action and other processes.

Sodium, calcium potassium, chlorine, phosphate and magnesium are all electronic electrolytes.

Level of electrolytes in our body's can become too low or too high.

That can happen when the amount of water in our body change causing dehydration,cause include some medicines,vometing, diarrhoea, sweating or kidney problems.

SPECIFIC CONDITION

Hyponatremia.          Lack of Sodium

Hypernatremia.        Excess of Sodium

Hypokalemia .           Lack if Potassium

Hyperkalemia .         Excess of Potassium

Hypomagnesemia .  Lack of Magnesium

Hypermagnesemia.   Excess of Magnesium

Hypocalcemia.          Lack of Calcium

Hypercalcaemia .     Excess of Calcium

Hypophosphatemia . Lack of Phosphate

Hyperphosphatemia . Excess of phosphate

Hypoglycemia.             Lack of Glucose

Hyperglycemia .           Excess of Glucose

             1.      HYPONATREMIA

DEFINITION

It is a condition of electrolyte imbalance in which sodium ion concentration in the serum/blood is lower than normal range.

Normal serum sodium level ------- 135-145 mEq/L

Hyponatremia ---- below the 135 mEq/L

CAUSES

• CHF
• Oedema
• Diarrhoea
• Lack of sodium intake
• Kidney disease (Nephrotic syndrome)
• Lack of secretion of adrenal hormone
• Liver cirrhosis
• Vomiting
• Excessive sweating.

SIGN/SYMPTOMS

• Nausea vometing
• Headache
• Confusion
• Lethargy
• Fatigue
• Loss of appetite
• Restlessness
• Irritability
• Seizures
• Coma
• Abdominal pain
• Cold skin
• Rapid/weak puls.

TREATMENT

• Treatment depends on the underlying causes, e.g., CHF, kidney disorders.
• Intravenous administration of normal saline.
• Increase sodium intake in diet
• Monitor blood pressure.

           2.    HYPERNATRAEMIA

DEFINITION

It is a condition of electrolyte imbalance in which sodium ion concentration in serum/blood is higher than normal (above 145 mEq/L).

Causes

• Renal disorder
• Severe watery diarrhoea
• Rapid over NS infusion
• Inadequate
• Inadequate intake of water
• Excessive loss of water from the urinary tract
• Water loss associated with extreme sweating.

SIGN/SYMPTOMS

• Lethargy
• Oedema
• Weakness
• Irritability
• Seizures
• Coma
• Oliguria/Anuria
• Increase desire of thirst
• Neuromuscular excitability.

TREATMENT

• Treat underlying causes
• Maintain intake/output chart
• Provide solt restricted diet.
• Daily wait check.
• Administration of force water to correct the relative water deficit.

                  3.    HYPKALEMIA

DEFINITION

It is condition of electrolyte imbalance in which Potassium in concentration in flood is lower than normal range.

Normal range ----   3.5-4.5  mEq/L.

CAUSES

• Vomiting
• Diarrhoea
• Renal disorders
• Cushing syndrome
• Self induced vomiting
• Very low calorie diet
• Alcohol abuse
• Poor dietary intake of Potassium
• Drugs.

Sign/Symptoms

• Myalgia
• Muscle cramps
• Flaccid paralysis
• Muscles weakness
•  Respiratory depression
• Elevation of flood pressure
• Impairment of skeletal muscle function.

TREATMENT

• Treat underlying causes, e.g., diarrhoea,vomiting, stopping medication.
• Potassium---containing food should be recommended, e.g., green vegetables, tomatoes, coconut water, citrus fruits, orange, banana. In servere hypokalemia, need intravenous fluids.

                   4.  HYPERKALEMIA

DEFINITION

Potassium level is higher than normal, or above 5 mEq/L.

CAUSES

• Renal disorders
• Excessive intravenous fluid administration.

                            Key of Machine

M ---- Medications

A  ---- Acidosis

C  ---- Cellular destruction

H ---- Hyperaldosteronism

I  ---- Inadequate intake

N ---- Nephrons failure

E ---- Excretion impaired.

SIGNS/SYMPTOMS

                     Keys of Murder

M --.   Muscle weakness

U -- .   Urinary problem

R --     Respiratory distress

D --.    Decreased cardiac contractility

E -- .   ECG change

R --     Reflexes change

TREATMENT

• Reduce dietary potassium
• Insulin therapy (10-50 unit of regular insulin with 50 ml of 50% dextrose to prevent hypoglycemia). will lead to a shift of potassium ions into cells.
• Bicarbonate therapy.
• Salbutamole by nebulization, e.g., 10-20 ml. This drug lowers blood level of K+ by promoting its movement into cells).
• Hemodialysis or hemofiltration in severe conditions.
• Diuretics, e.g., furosemide.

                  5.   HYPOCALCEMIA

DEFINITION

It is a condition in which calcium level in blood is less than nirmal range. Normal calcium level 9-10.5 mg/dl.

CAUSES

• Vit. D deficiency
• Acute rental failure.
• Poor intake of Vit. D/calcium.
• Excessive dietary magnesium.
• Parathyroid hormone deficiency.
• Osteoporosis treatment (bisphosphonates).
• Prolonged use of medication/laxatives containing magnesium.

SIGN/SYMPTOMS

• Paresthesias
• Tetany
• Cardiac arrhythmias
• Laryngospasm
• Tondon reflex are hyperactive
• Tingling or pins and needle sensation
• Purpura

MANAGEMENT

• IV calcium gluconate 10%
• Calcium and Vit. D supplement.

     

                6.    HYPERCACEMIA

DEFINITION

It is a condition in which calcium level in blood is higher than normal range (abive10.5 mg/dl).

CAUSES

• Hyperparathyroidism
• Tumour
• Hypervitaminosis D
• Use of lithium and thiazide
• Renal failure
• Parathyroid carcinoma
• Over treated hypocalcemia
• Hyperthyroidism
• Paget's disease of bone

Sign/Symptoms

• Polyuria 
• Nausea/vomiting
• Anxiety
• Insomnia
• Fatigue
• Es gastric production (peptic unclear)
• Abdominal pain
• Depression
• Cognitive dysfunction
• Coma
• Anorexia

TREATMENT

• Treatment of underlying cause.
• Fluid and diuretics therapy.
• Bisphosphonates and calcitonin therapy.
• Glucocorticoids.
• Dialysis usually used in severe hypercalcemia.