ELECTROLYTES. Are particles that carry electrical charge and are present in blood, plasma and urine....
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Transcript of ELECTROLYTES. Are particles that carry electrical charge and are present in blood, plasma and urine....
ELECTROLYTES
Are particles that carry electrical charge and are present in blood, plasma and urine.
Substances whose molecules dissociate into
ions when placed into water cations- positively charged e.g Na+, K+, Mg++, Ca++
anions – negatively charged e.g Cl - ,
What is an electrolyte?
Essential minerals necessary for nerve and muscle function
Maintain body fluid balance Regulate acid base balance
Electrolytes
Positive cations : potassium K+, sodium Na +, magnesium Mg2+, calcium 2+
Negative cations :
phosphate PO4 3-, chloride Cl_
Buffer : bicarbonate HCO3-
Types of electrolytes
Intracellular fluid (ICF) :- prevalent cation – K+, Mg++ prevalent anion - PO4
- - -
Extracellular fluid ( ECF) :- prevalent cation – Na+
prevalent anion - Cl-
Distribution
Transmission and conduction of nerve and muscle impulse
Required for repolarization of cell membrane to a resting state after an action potential
Maintenance of cardiac rhythms Acid base balance Normal : 3.5 -4.5 mmol/l
POTASSIUM or K+
High serum K caused by :- massive intake impaired renal secretion shift from ICF to ECF : massive cell
destruction e.g brain injury, crush injury
Hyperkalaemia
Manifestation :Weak or paralysed skeletal musclesVF or cardiac standstillSmall P waves and high peaked T waves REMEMBER ALS GUIDELINES
Hyperkalaemia
CORRECTION increase elimination ( diuretics, dialysis)Force K+ from ECF to ICF by IV insulin with
dextrose or sodium bicarbonatereverse membrane effects of elevated ECF
K+ by administrating Calcium Gluconate IV
Hyperkalaemia
CAUSES : Kidney malfunction Diabetic ketoacidosis Gastrointestinal tract losses : vomiting,
diarrhoeaMg deficiency : alcohol abuse Metabolic alkalosis
HYPOKALAEMIA
Clinical signs / CorrectionCardiac arrthymias : gradual sagging ST
segment, flattening of T waves , appearance of U wave
Severe muscle weakness shallow respiration : threatening respiratory
functionCorrection : oral or IV
HYPOKALAEMIA
Most prevalent cation in ECF Plays a major role :-
ECF volume and concentration : retain body water Generation and transmission of nerve impulsepH balance Normal concentration : 135- 145 mmol/l
SODIUM or Na+
Elevated serum sodium: mostly water deficit causes hyper osmolality lead to cellular
dehydration Primary protection: thirst mechanism from
hypothalamus
Hypernatraemia
Clinical signs Seizures, coma leading to irreversible brain damage
Correction : not with WATER !!
Giving NaCl solution or with addition to dextrose: gradually reduced to avoid cerebral oedema
Hypernatraemia
Causes: Low Na in plasma caused by liver failure, kidney failure and
overhydration . Proportional to excess water :SIADH (syndrome of
inappropriate anti-diuretic hormone secretion)Manifestation : nausea, vomiting, headache, confusion, lethargy ,
restlessness, muscle weakness, spasms, cramps, seizures, coma .
Non cardiogenic pulmonary oedema .
Hyponatremia
Correction :- Find the cause Hypervolemia : both water and sodium level high liver cirrhosis, CHF, correction :- address liver and cardiac function Euvolaemic hyponatremia: excess water but body Na+ level is
same Hypothoridism , steroid (glucosteroid deficiency )
Correction : water restriction Hypovolaemic hyponatraemia : both water and sodium low prolonged vomiting, severe diarrhoea, decreased oral intake ,
diuretic use Correction : administration of NaCl.
Hyponatremia
2nd most abundant cation in ICF Energy metabolism : glucose utilisation ,
fatty acid synthesis, muscle contraction Na+ – K + pump Affects Ca ++ homeostasis Release and action of PTH
Magnesium
Malabsorption : inflammatory bowel diseaseAlcoholism Following parathyrodiectomyHypercalaemia
Correction : IV MgSO4
Hypomagnesaemia
Block synaptic transmission : deep tendon reflexes
Effect on smooth muscles : ileus and urinary retention
Bradycardia and hypotension : effects on Ca+
+ & K +
Correction:IV Ca++ Renal patient : dialysis
Hypermagnesaemia
Transmission of nerve impulse Muscle contraction :Myocardial Blood clotting Formation of bones and teethBalance controlled by : parathyroid hormone Calcitonin Vitamin D
CALCIUM
Eating disorderLack of parathyroid hormone
Hypocalcaemia
Hyper parathyroid hormoneVitamin D overdoseProlonged immobilisation
Hypercalcaemia
Decreased memory Confusion , fatigue Constipation
Correction :- excretion of excess Ca++ with loop diuretics
Hydration with isotonic saline
Clinical symptoms
Maintains acid-base status Kidney regulation Good indictors of acid-base balance
Bicarbonates HCO3
_
THANK YOU
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