Electrolyte Imbalance

HypoCalcemia
HyperCalcemia
HypoKalemia
HyperKalemia

HypoMagnesemia
HyperMagnesemia

Electrocardiographic Changes
Prolonged ST interval
Prolonged QT interval
Shortened ST segment
Widened T wave
ST Depression
Shallow, flat, or inverted T wave
Prominent U wave
Tall peaked T waves
Flat P waves
Widened QRS complex
Prolonged PR interval
Tall T waves
Depressed ST segment
Prolonged PR interval
Widened QRS complex

Sample Questions:
1. A nurse reviews a clients electrolyte laboratory report and
notes that the postassium level is 3.2 mEq/L. Which of the
following would the nurse note on the ECG as a result of the
laboratory value?
a. Elevated T waves
b. Absent P waves
c. Elevated ST Segment
d. U waves
2. A nurse reviews the electrolyte results of an assigned client
that the K+ level is 5.4 mEq/L. Which of the ff. would the nurse
expect to note on the cardiogram as a result of the laboratory
value?
a. Tall peaked T waves
b. Prominent U wave
c. ST depression
d. Inverted T waves
3. A nurse caring for a client with severe malnutrition reviews the
lab results and notes a magnesium level of 1.0 mg/dL . Which
electrocardiogram change would the nurse note based on the
magnesium level?
a. Prominent U wave
b. Depressed ST segment
c. Widened QRS complexes
d. Prolonged PR interval

Answers and Rationale:

1.
a.
b.
c.
d.

Elevated T waves
Absent P waves
Elevated ST Segment
U waves

Rationale: A serum K level of less than 3.5 mEq/L indicates hypokalemia. ECG
changes include inverted T waves, ST segment depression and prominent U
waves.
2.
a.
b.
c.
d.

Tall peaked T waves

Prominent U wave
ST depression
Inverted T waves

Rationale: A serum potassium level greater than 5.4 mEq/L indicates

hyperkalemia. ECG changes include flat P waves, prolonged PR intervals,
widened QRS complexes, and tall peaked T waves.
3.
a.
b.
c.
d.

Prominent U wave
Depressed ST segment
Widened QRS complexes
Prolonged PR interval

Rationale: The normal Mg level is 1.6 to 2.6 mg/dL. A magnesium level of 1.0
mg/dL indicates hypomagnesemia. The nurse would indicate tall T waves and
depressed ST segment. Option C and D would be seen in a ct exp
hypermagnesemia. Prominent U waves would be seen in hypokalemia.