Electrolytes- NURS 2106 EXAM I
6 L's - ANS-Mnemonic for S/S's of Hypokalemia:
Lethargy, Leg cramps, Limp muscles, Low/shallow respirations, Lethal cardiac
dysrhythmias, LOTS of urine
CATSS go Numb - ANS-Mnemonic for S&S's of Hypocalcemia: Convulsions,
Arrhythmias, Tetany, Spasms, Stridor, and Numbness around mouth and fingertips.
Causes of hypercalcemia - ANS--Increased total calcium: hyperparathyroidism,
malignancy (bone cancers esp.), prolonged imobilization, vit D overdose, thiazides,
milk-alkali.
-Increased ionized calcium: Acidosis
Causes of Hyperchloremia - ANS-Dehydration (vomiting, diarrhea, sweating or fever,
excessive dilute urine production). Hypernatremia. Renal disease/disorder. Androgens,
corticosteroids, estrogens and diuretics.
Causes of Hyperkalemia - ANS--Excessive K intake (parenteral admin or salt sub)
-Rapid transfusion of hemolyzed blood
-Fluid vol deficit
-Shift of K out of cells: Acidosis, DKA, tissue destruction (fever, sepsis, burns, crush,
tumor lysis, exercise)
-Failure to eliminate K: Renal failure*, meds (K sparing diuretics, ACE-I, ARB,
β-blockers, spironolactone (aldactone), triamterene, K-penicillin), adrenal insufficiency
Causes of Hypermagnesemia - ANS-Renal failure (esp if given Mg products)
Excessive administration of Mg for treatment of eclampsia
Causes of Hypernatremia - ANS--Excessive Na intake (hypertonic NaCl, excessive
isotonic NaCl, IV NaCO3, hypertonic tube feedings w/o water supplementation, near
drowning in salt water)
-Inadequate water intake
-Excessive water loss (fever, heatstroke, prolonged hyperventilation, osmotic diuretics,
diarrhea
-Disease- Diabetes Ins., hyperaldsteronism, Cushings, uncontrolled DM
Causes of Hyperphosphatemia - ANS-Renal Failure
Chemotherapy r/t leukemia & lymphomas
, Fleet enema
Excessive milk, phos-laxatives, or Vit D ingestion
Hypoparathyroidism (↓Ca ↑PO4)
Causes of Hypocalcemia - ANS-1) Decreased TOTAL Ca: Chronic renal disease, ↑
PO4, hypoPTism/PT injury, ↓ Vit D, ↓ Mg, pancreatitis, loop diuretics, chronic
alcoholism, diarrhea, ↓ serum albumin.
2) Decreased IONIZED Ca: Alkalosis, excessive citrated blood administration
Causes of Hypocholremia - ANS-Dehydration: Vomiting, diarrhea, N/G suctioning,
fistula drainage, high fever.
Use of loop or thiazide diuretics, bicarb, corticosteroids, diuretics, laxatives.
May result in metabolic alkalosis.
Causes of Hypokalemia - ANS-1) Abnormal Sweating/GI/GU loss (↑UOP, diuresis,
diarrhea, laxative abuse, vomiting, ileostomy drainage, NG Drainage)
2) Hyperaldosteronism
3) Shift of K into cells (Insulin, Alkalosis, β andrenergic stimulation, rapid cell building
(folic acid, B12, EPO)
4) Mg depletion (↓Mg→↑Renin→↑Aldosterone→↑excretion of K)
5) DKA treatment
6) Dialysis
7) Decreased intake of K
Causes of Hypomagnesemia - ANS--Chronic malnutrition (alcoholism, starvation)
-GI/GU Fluid loss (Diarrhea, vomiting, impaired absorption, NG suctioning, large UO r/t
diuretics or hyperglycemia)
-Poorly controlled DM
-Hypomagnesemia associated w/ hypokalemia that does not respond to K replacement
Causes of Hyponatremia - ANS-Excessive GI losses (diarrhea, vomiting, fistulas, NG
suctioning), sweating, diuretics, adrenal insufficiency
Excessive water gain (hypotonic IV therapy)
Disease (heart failure, hypoaldosteronism, SIADH)
Decreased intake (fasting)
Causes of Hypophosphatemia - ANS-Malabsorption, nutritional recovery syndrome,
glucose administration, TPN, ETOH withdrawal, PO4 binding antacids, DKA recovery,
Resp. Alk