ELECTROLYTE IMBALANCE

Ms. K. HEMA ANANDHY,

M.Sc NURSING
Puducherry

INTRODUCTION
WATER IS THE MOST IMPORTANT NUTRIENT OF

LIFE.
PROVIDE A MEDIUM FOR TRANSPORTING
NUTRIENTS TO CELLS AND WASTES FROM CELLS
&HORMONES, ENZYMES,RBCS WBCS.
FACILITATE CELLULAR METABOLISM.
ACT AS SLOVENT FOR ELETROLYTES& NON
ELECTROLYTES.
MAINTAIN BODY TEMP.
DIGESTION PROMOTE ELIMINATION.
ACT AS TISSUE LUBRICANT.

ELETROLYTES
ION_ IS AN ATOM OR MOLECULE CARRYING AN

ELETRICAL CHARGE.SUBSTANCES CAPABLE OF

BREAKING INTO ELETRICALLY CHARGED IONS
WHEN DISSOLVED IN A SOLUTION ARE CALLED
ELETROLYTES.
POSITIVE CHAGE CATIONS
NEGATIVE CHARGE ANIONS.

OSMOSIS
LESS CONCENTRATION TO GREATER

CONCENTRATION.
OSMOLARITY:
PULLING POWER.
ISOTONIC SOLUTION, HYPERTONIC ,HYPOTONIC
SOLUTION.
DIFFUSION : HIGHER CON LOW CON
ACTIVE TRANSPORT

HYPERNATREMIA
SODIUM >145 MEQ/L OR MMOL/L

FLUID INTAKE

FLUID OUTPUT

KIDNEYS
SKIN

INGESTED WATER

INGESTED FOOD

METABOLIC OXIDATION

INSENSIBLE LOSS
SENSIBLE LOSS
GIT

ACID BASE IMBALANCES

RESPIRATORY ACIDOSIS: EXCESS OF

CARBONIC ACID IN ECF.

RESPIRATORY ALKALOSIS: DEFICIT OF CARBONIC
ACID.
METABOLIC ACIDOSIS OR NON
RESPIRATORYACIDOSIS: A DEFICIT OF
BICARBONATE IN ECF.
M .ALKALOSIS: EXCESSOF BICARBONATE.

NORMAL VALUES
CATIONS
POTASSIUM
MAG
CALCIUM
SODIUM

3.5 -5.5 MEQ/L

1.5 -2.5 MEQ/L
9_11 mg/dl
135-145 MEQ/L

ANIONS
BICORBONATE
PHOSPHATE
PROTEIN

20-30 MEQ/L
96-106 MEQ/L
6-8 g/dl

HYPONATREMIA

IT RESULT OF LOSS OF SODIUM

CONTAINING FLUIDS OR WATER EXESS AND
SHIFT WATER IN TO THE CELL

HYPERNATREMIA
EXCESS SODIUM IN ECF.

POTASSIUM IMBALANCES
POTTASIUM IS THE MAJOR ICF CATION WITH

98% OF THE BODY

K +
BEGIN
INTRACELLULAR.
FUCTION: TRANSMISSION AND CONDUCTION
OF NERVE IMPULES, MAINTENANCE OF
NORMAL CARDIC RHYTHAM AND SKELETAL
MUSCEL &SMOOTH MUSCLE CONTRACTION.

HYPERKALEMIA
KIDNEY IS THE PRIMARY SOURCE OF K+ LOSS.
IT MAY BE CAUSED BY MASSIVE INTAKE OF K+,

IMPAIRED RENAL FUNCTION,SHIFT OF K+

FROM ICF TO ECF OR COMBINATION OF
THSES. BURNS, CRUSH INJURY, SEVER
INFECTIONS, SOME DRUGS .

C/M
IRRITABILITY
AB.PAIN
WEAKNESS OF LOWER EXTREMITIES
IRREGULAR PULSE
ECG CHANGES;
TALL PEAKED T WAVE, PROLONGED PR

INTERVEL,ST DEPRESSION, WIDENING QRS

MANAGEMENT
DIALYSIS
CORDIAC MONITORING.

HYPOKALEMIA
NORMAL VALUES 3.5-5.5MEQ/L
ABNORMAL LOSSES OF K+
C/M
FATIQUE, MUSCLE WEAKNESS, LEG CRAMPS,N,

VOMITING,HYPERGLYCEMIA, POLYURIA.

MANAGEMENT
PO CHOLIRIDE ADMINISTRATION 0.5ML/KG OF
BODY WEIGHT .

CALCIUM IMBALANCES
HYPOCALCEMIA < 9 Mg/dl

HYPERCALCEMIA >11 mg/d

Increased ca intake
Multiple myeloma
Malignancy

Causes

Decreased ca intake.

Immobilization
Hyper parathyroidsim
Vit. Over dose
Diureatics
INCREASED IONIZED CA
acidosis

c/m ca imbalances
Hypo calcemia
Muscle cramps
Chvosteks sign
Trousseaus sign
Laryngeal spasm

Hyper calcemia

Nephrolithiasis

Tetany

All the above.

PHOSPHATE IMBALANCES
PHOSPHORS IS A PRIMARY ANION IN THE ICF &

IS ESSENTIONAL TO THE FUNCTION OF THE

MUSCLE, RBCS, NERVOUS SYSTEM. IT IS
DEPOSITED WITH CALCIUM FOR BONE &
TOOTH STRUCTURE. IT ALSO USED ACID BASE
BURRING SYSTEM ATP,USE GLUCOSE&
METABOLISM CHO, PROTIEN, FAT.

HYPOPHOSPHATEMI
A

CAUSES

HYPERPHOSPHATEM
IA

RENAL FAILER

Malabsorption syndrome

Tpn

Alcohol withdrawl

EXCESSIVE INGESTION

Dka

Respiratory alkalosis

HYPOPARATHYROIDISM

CHEMOTHERPEUTIC DRUG

MAGNESIUM IMBALANCES
IT IS A 2ed MOST ICF CATION. MAG IS ACT

DIRECTLY ON THE MYONEURAL JUNCTION

,NEUROMUSCULAR EXCITABILITY IS AFFECTED
IN S. MAGNESIUM
CLINICAL MANIFESTATION:
CNS IRRITABILITY( HYPOMAGNESEMIA)
LETHARGY, DROWSINESS,CARDIAC ARREST.
(HYPERMAGNSEMIA)

PROTEIN IMBALANCES CAUSES

HYPOPROTENIMIA

DECREASED FOOD INTAKE,LIVER

DISORDERS,BURNS, LOSS ALBUMIN IN RENAL
DISORDERS, INFECTION.

HYPERPROTEINMIA

DEHYDRATION
HEMOCONCENTRATION

ASSESSMENT
COMPARISON OF TOTAL INTAKE &OUTPUT

CHART.
SKIN COLOUR
DEGREE OF MOISTURE IN ORAL CAVITY
THIRST
NAUSEA,VOMITING, DIARRHOEA, WOUNDS OR
FLUIDS.

THANK
YOU