I am a major cation of ICF; normal serum concentration is: 3.5–5.0 mEq/L

Controls intracellular osmolality

Regulator of cellular enzyme activity

Role in the transmission of electrical impulses in nerve, heart, skeletal, intestinal, and lung tissue;

Regulation of acid–base balance by cellular exchange with H+ Adequate quantities via a well-balanced diet Leading food sources: fruits and vegetables, dried peas and beans, whole grains, milk, meats Lost via kidneys, stool, sweat, emesis Regulated by aldosterone

Eliminated by the kidneys (no effective method of conserving me)

Who am I?

Additional regulation via transcellular shift between the ICF and ECF compartments

(a)  

I am the second most abundant ICF cation after potassium; normal serum concentration is: 1.3–2.3 mEq/L

Metabolism of carbohydrates and proteins

Role in neuromuscular function

Acts on cardiovascular system, producing vasodilation

Enters the body via gastrointestinal tract

Sources include green, leafy vegetables; nuts; seafood; whole grains; dried peas and beans; cocoa Lost via urine with use of loop diuretics

Eliminated by kidneys Regulated by parathyroid hormone

Who am I?

(a)  

I am a major ECF anion; normal serum level is: 97–107 mEq/L

Major component of interstitial and lymph fluid; gastric and pancreatic juices, sweat, bile, and saliva

Acts with sodium to maintain the osmotic pressure Combines with hydrogen ions to produce hydrochloric acid

Enters body via gastrointestinal tract

Almost all of me in the diet comes from salt

Found in foods high in sodium, processed foods Normally paired with sodium; excreted and conserved with sodium by the kidneys

Regulated by aldosterone

Low potassium level leads to low levels of me.

Who am I?

(a)  

I am an anion that is the major chemical base buffer within the body; found in both ECF and ICF; normal serum level: 25–29 mEq/L

Regulates acid–base balance

Losses possible via diarrhea, diuretics, and early renal insufficiency

Excess possible via over-ingestion of acid neutralizers, such as sodium bicarbonate

My levels are regulated primarily by the kidneys

I am readily available as a result of carbon dioxide formation during metabolism

Who am I?

(a)  

Anorexia, nausea and vomiting, headache, lethargy, dizziness, confusion, muscle cramps and weakness, muscular twitching, seizures, papilledema, dry skin, ↑ pulse, ↓ BP, weight gain, edema

Labs indicate: ↓ serum and urine sodium, ↓ urine specific gravity and osmolality

(a)  

Thirst, elevated body temperature, swollen dry tongue and sticky mucous membranes, hallucinations, lethargy, restlessness, irritability, simple partial or tonic–clonic seizures, pulmonary edema, hyperreflexia, twitching, nausea, vomiting, anorexia, ↑ pulse, and ↑ BP

Labs indicate: ↑ serum sodium, ↓ urine sodium, ↑ urine specific gravity and osmolality, ↓ CVP

(a)  

Fatigue, anorexia, nausea and vomiting, muscle weakness, polyuria, decreased bowel motility, ventricular asystole or fibrillation, paresthesias, leg cramps, ↓ BP, ileus, abdominal distention, hypoactive reflexes.

ECG: flattened T waves, prominent U waves, ST depression, prolonged PR interval

(a)  

Muscle weakness, tachycardia → bradycardia, dysrhythmias, flaccid paralysis, paresthesias, intestinal colic, cramps, abdominal distention, irritability, anxiety.

ECG: tall tented T waves, prolonged PR interval and QRS duration, absent P waves, ST depression

(a)  

Numbness, tingling of fingers, toes, and circumoral region; positive Trousseau sign and Chvostek sign; seizures, carpopedal spasms, hyperactive deep tendon reflexes, irritability, bronchospasm, anxiety, impaired clotting time, ↓ prothrombin, diarrhea, ↓ BP.

ECG: prolonged QT interval and lengthened ST

Labs indicate: ↓ Mg++ (don't let this fool you ;))

(a)  

Muscular weakness, constipation, anorexia, nausea and vomiting, polyuria and polydipsia, dehydration, hypoactive deep tendon reflexes, lethargy, deep bone pain, pathologic fractures, flank pain, calcium stones, hypertension.

ECG: shortened ST segment and QT interval, bradycardia, heart blocks

(a)  

Neuromuscular irritability, positive Trousseau sign and Chvostek sign, insomnia, mood changes, anorexia, vomiting, increased tendon reflexes, and ↑ BP.

ECG: PVCs, flat or inverted T waves, depressed ST segment, prolonged PR interval, and widened QRS

(a)  

Flushing, hypotension, muscle weakness, drowsiness, hypoactive reflexes, depressed respirations, cardiac arrest and coma, diaphoresis.

ECG: tachycardia → bradycardia, prolonged PR interval and QRS, peaked T waves

(a)  

Paresthesias, muscle weakness, bone pain and tenderness, chest pain, confusion, cardiomyopathy, respiratory failure, seizures, tissue hypoxia, and increased susceptibility to infection, nystagmus

(a)  

Tetany, tachycardia, anorexia, nausea and vomiting, muscle weakness, signs and symptoms of hypocalcemia; hyperactive reflexes; soft tissue calcifications in lungs, heart, kidneys, and cornea

(a)  

Agitation, irritability, tremors, muscle cramps, hyperactive deep tendon reflexes, hypertonicity, tetany, slow shallow respirations, seizures, dysrhythmias, coma

Labs indicate: ↓ serum chloride, ↓ serum sodium, ↑ pH, ↑ serum bicarbonate, ↑ total carbon dioxide content, ↓ urine chloride level, ↓ serum potassium

(a)  

Tachypnea, lethargy, weakness, deep rapid respirations, decline in cognitive status, ↓ cardiac output, dyspnea, tachycardia, pitting edema, dysrhythmias, coma

Labs indicate: ↑ serum chloride, ↑ serum potassium and sodium, ↓ serum pH, ↓ serum bicarbonate, normal anion gap, ↑ urinary chloride level

(a)  

Name 5 nursing interventions for a patient with low sodium?

Name 5 nursing interventions for a patient with high potassium?

Give 2 examples of patient education for a patient requiring a magnesium supplement?