Electrolyte Imbalance

Electrolyte Imbalance

Maintenance of body homeostasis is heavily dependent on the electrolytes. Alterations in the composition of electrolytes normally affect the normal physiologic functionalities of the body and have been implicated in various pathological conditions. The major electrolytes in the body include sodium, potassium, calcium, magnesium, and chloride. Sodium is the most abundant cation in the extracellular fluid, while potassium is the most abundant cation in the intracellular fluid. The electrolyte selected is sodium.

Sodium is vital in various physiological processes. It is essential in nerve impulse conduction and water balance maintenance, among others. The normal laboratory ranges of sodium are between 135-145mmol/L. Values outside this physiological range are regarded as abnormal and may be implicated in several pathologies. A rise in serum sodium to values exceeding 145mmol/L is referred to as hypernatremia. Conversely, a decline in serum sodium to a value below 135mmol/L is referred to as hyponatremia.

Hyponatremia defines deficiency of serum sodium. Hyponatremia can be caused by several factors. Medications such as diuretics often lead to urinary losses of sodium with the potential to cause hyponatremia. Excessive fluid intake as well leads to a watering effect on sodium and may result in hyponatremia. Certain underlying pathologies have also been implicated in hyponatremia. Such disorders as Syndrome of Inappropriate Antidiuretic Hormone (SIADH), causes dilutional hyponatremia by a watering effect attributable to excessive water retention (Dineen, Thompson & Sherlock, 2017). Hypernatremia, on the other hand, can be caused by inadequate hydration, excessive water loss, diarrhea, vomiting, and increased salt intake, although in rare circumstances.

Hyponatremia is characterized by several symptoms. These include nausea and vomiting, headache, confusion, hypotension, muscle cramping, and twitching, lethargy, and coma. Death can occur in severe cases. Hypernatremia, on the other hand, commonly presents with excessive thirst. Fatigue and confusion can also be observed. Severe hypernatremia can cause seizures, and death can also occur.

Treatment of hyponatremia is often dependent on the cause. Treatment of the underlying cause successfully relieves hyponatremia that is attributable to an underlying pathology. Hyponatremia caused by medication use is treatable by down titration of the doses of the medication in question, and when necessary and rational, the substitution of the medication can be done. Fluid restriction often relieves hyponatremia caused by sodium dilution. Replacement therapy by intravenous infusion of sodium-containing solutions adequately upsets hyponatremia (Dineen, Thompson & Sherlock, 2017). Sodium retaining drugs and dialysis as well offsets hyponatremia, with the latter working by decreasing fluid retention.

Treatment of hypernatremia also involves treating the underlying cause as well as fluid and sodium balance correction. Increasing fluid intake effectively offsets hypernatremia. This can be done by intravenous infusions of fluids in severe cases or just by drinking adequate amounts of fluids (Qian, 2019). Fluid correction should be monitored as aggressive fluid correction by intravenous infusion may cause hyponatremia.

Sodium remains to be a vital electrolyte in the body. Its significance in maintaining normal body homeostasis underpins its usefulness. Serum sodium values outside the physiologic range of between 135mmol/L and 145mmol/L often alter the normal physiological functionality. Hyponatremia is defined as serum sodium below 135mmol/L, while hypernatremia is defined as serum sodium above 145mmol/L. These clinical conditions are characterized by several clinical symptoms and their treatment often follows their respective causes as well as replacement therapy as seen with hyponatremia.

 

Electrolyte Normal Range	Causes of Hypernatremia	Signs and symptoms of Hypernatremia	Treatment of Hypernatremia	Causes of Hyponatremia	Signs and symptoms of Hyponatremia	Treatment of Hyponatremia
135mmol/L-145mmol/L	Inadequate fluid intake, which allows sodium to be concentrated in the extracellular compartment.   Too much fluid loss leads to the concentration of sodium in the extracellular fluid compartment.   Excessive dietary consumption of sodium which increases the sodium pool in the extracellular compartment.	Excessive thirst due to increased osmolality of the blood.   Seizures due to shrinkage of the brain, which in turn provoke seizure episodes.   Fatigue due to decreased muscle activity.	Increasing fluid intake. This can either be by intravenous infusion in severe cases or by oral hydration. Fluid intake expands plasma volume and has a watering effect on excess sodium and consequently corrects the hypernatremia.	Underlying disease conditions such as syndrome of inappropriate antidiuretic hormone that causes dilutional hyponatremia.   Medications such as diuretics cause loss of sodium and have the potential to cause hyponatremia.   Excessive fluid intake often causes a washdown effect that consequently manifests as hyponatremia.	Hypotension due to a decrease in the contractility of the heart.   Muscle cramping   Lethargy due to a decrease in muscle activity	Fluid restriction to prevent the washing away effect attributed to the high extracellular fluid amount.   Replacement therapy with sodium-containing fluids to replenish the lost sodium.   Treatment of underlying cause.

References

Dineen, R., Thompson, C., & Sherlock, M. (2017). Hyponatremia – presentations and management. Clinical Medicine, 17(3), 263-269. DOI: 10.7861/clinmedicine.17-3-263

Qian, Q. (2019). Hypernatremia. Clinical Journal Of The American Society Of Nephrology, 14(3), 432-434. DOI: 10.2215/cjn.12141018

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Select an electrolyte from the list in the document linked below. Using references that you may already have identified, indicate conditions caused by too much or too little of that electrolyte. In the first column with the identified electrolyte, write the normal lab value range and cause of imbalance. After you have identified the hyper- and hypo-conditions

After you have identified the hyper- and hypo-conditions, also identify the treatment of those conditions.

Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.