⚡ Electrolytes
Electrolyte Imbalances
Quick reference for sodium, potassium, calcium, magnesium, and phosphorus imbalances — signs, symptoms, and treatment.
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Sodium (Na+)
| Test / Parameter | Normal Range | Clinical Notes |
|---|---|---|
| Normal Range | 135–145 mEq/L | |
| Hyponatremia (<135) | Confusion, headache, nausea, seizures | SIADH, diuretics, heart failure. Correct slowly (≤8–12 mEq/24h) to avoid osmotic demyelination. |
| Hypernatremia (>145) | Thirst, agitation, seizures, coma | Dehydration, DI. Correct slowly over 48h with D5W or oral water. |
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Potassium (K+)
| Test / Parameter | Normal Range | Clinical Notes |
|---|---|---|
| Normal Range | 3.5–5.0 mEq/L | |
| Hypokalemia (<3.5) | Weakness, cramps, arrhythmias, U waves on ECG | Diuretics, vomiting, diarrhea. Replace PO or IV (max 10 mEq/hr peripheral). |
| Hyperkalemia (>5.0) | Peaked T waves, widened QRS, arrhythmias | Renal failure, ACEi, K-sparing diuretics. >6.5: emergency. Calcium gluconate first (stabilize heart). |
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Calcium (Ca+)
| Test / Parameter | Normal Range | Clinical Notes |
|---|---|---|
| Normal Range | 8.5–10.5 mg/dL (total) 4.5–5.1 mg/dL (ionized) | |
| Hypocalcemia (<8.5) | Tetany, Chvostek sign, Trousseau sign, seizures | Thyroid/parathyroid surgery, vitamin D deficiency, hypomagnesemia. Treat with calcium gluconate IV. |
| Hypercalcemia (>10.5) | "Stones, bones, groans, moans" | Malignancy, hyperparathyroidism. Treat: IV fluids, bisphosphonates, calcitonin. |
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Magnesium (Mg+)
| Test / Parameter | Normal Range | Clinical Notes |
|---|---|---|
| Normal Range | 1.7–2.2 mg/dL | |
| Hypomagnesemia (<1.7) | Tremors, arrhythmias, hypocalcemia, hypokalemia | Alcoholism, diuretics, PPIs. Replace IV magnesium sulfate (monitor reflexes and RR). |
| Hypermagnesemia (>2.2) | Loss of reflexes, hypotension, respiratory depression | Renal failure, excessive replacement. Treat: calcium gluconate, hemodialysis. |
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Phosphorus (PO4)
| Test / Parameter | Normal Range | Clinical Notes |
|---|---|---|
| Normal Range | 2.5–4.5 mg/dL | |
| Hypophosphatemia (<2.5) | Muscle weakness, respiratory failure, hemolysis | Refeeding syndrome, alcoholism, DKA. Replace slowly. |
| Hyperphosphatemia (>4.5) | Usually asymptomatic; ectopic calcification | Renal failure. Treat: phosphate binders (with meals), hemodialysis. |
electrolytessodiumpotassiumcalciummagnesiumphosphorus
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