Any trick to keep S/S of Electrolyte Imbalances straight??

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I always struggled with this in school and still am now as I study to retake my NCLEX-RN......I always seem to mix the hypo and hyper s/s up so if anyone has any tips/advice for me, that would be great!!!

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Specializes in ER, progressive care.

General points of information:

Na+ & K+ control muscles

Ca+ controls nerves

general symptom of all: muscle weakness, which is a priority because you gotta think about cardiac dysrhythmias. and in general if you know one, the other one will be opposite ;) Here are some very basic things I learned from my NCLEX class regarding s/s of electrolyte imbalances. I didn't list ALL of the causes associated with each one, just some of the more common ones.

Hyperkalemia - muscle weakness, cardiac dysrhythmias!!

EKG changes: tall T waves (think big K, big T!)

Causes: renal insufficiency/renal failure, metabolic acidosis, any kind of tissue injury/trauma/burns (K+ is predominantly intracellular, so when cells are damaged their contents are spewed out)

Treatment: insulin or bicarbonate to shift K+ from the ECF back into the ICF. you can also use kayexelate

Hypokalemia - muscle weakness, cardiac dysrhythmias!!

EKG changes: small T waves (think small K, small T!)

Causes: inadequate intake, potassium-wasting diuretics (thiazides and loops), vomiting/diarrhea

Treatment: give K

Hypercalcemia - "too much calcium = too calm" - you'll see muscle weakness & fatigue.

remember groans (constipation), moans (fatigue, lethargy), bones (bone pain), stones (kidney stones) and psychiatric overtones (depression & confusion) to help remember signs & symptoms.

EKG changes include a shortened QT interval.

Causes: hyperparathyroidism

Hypocalcemia is the opposite. you'll see tetany/muscle spasms, positive Chvostek's/Trousseau's signs, hyperactive DTRs, paresthesias in the fingers/extremities and around the mouth.

EKG changes include a prolonged QT interval.

Causes: hypoparathyroidism...also when a patient undergoes thyroid surgery/thyroidectomy, sometimes the parathyroid glands are accidentally removed = hypoparathyroidism.

Treatment: calcium gluconate

Hypermagnesemia

weakness, hyporeflexia (diminished or absent DTRs), cardiac dysrhythmias, respiratory depression. to help me remember hypermagnesemia, I just think of the OB patient or the patient going through ETOH withdrawal who might be getting a mag sulfate infusion and just think of what too much magnesium would equate to.

Causes: renal insufficiency, too much MgSO4

Treatment: calcium gluconate

Hypomagnesemia

muscle cramps, tremors, cardiac dysrhythmias, hyperactive DTRs, tetany...

Causes: insufficient dietary intake...you would give magnesium to correct the cause.

Treatment: give magnesium

Hypernatremia - extreme thirst, dry sticky mucous membranes, lethargy, weakness, irritability, seizures, coma (more severe)

Causes: basically not enough water...you're concentrated

Treatment: hold the sodium, give water (dilute it out)

Hyponatremia - headache, confusion, lethargy, irritability, muscle weakness...seizures, coma (more severe)

Causes: basically too much water...you're diluted! or increased loss of sodium (such as through the use of diuretics)

Treatment: hold the water, give sodium

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Thank you so much for this, I am hoping I dont freak out on my retake AGAIN lol I am such a bad test-taker but I refuse to let the NCLEX get me again!

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Thank you so much for this, I am hoping I dont freak out on my retake AGAIN lol I am such a bad test-taker but I refuse to let the NCLEX get me again!

he he he he , everyone is freaking out with this NCLEX thing. when are you going to take again?

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I like melosaur's groans, moans, bones, stones, and psychiatric overtones!

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Specializes in ER, progressive care.
Thank you so much for this, I am hoping I dont freak out on my retake AGAIN lol I am such a bad test-taker but I refuse to let the NCLEX get me again!

Good luck to you!!

I like melosaur's groans, moans, bones, stones, and psychiatric overtones!

That is how I was taught in nursing school! :)

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General points of information:

Na+ & K+ control muscles

Ca+ controls nerves

general symptom of all: muscle weakness, which is a priority because you gotta think about cardiac dysrhythmias. and in general if you know one, the other one will be opposite ;) Here are some very basic things I learned from my NCLEX class regarding s/s of electrolyte imbalances. I didn't list ALL of the causes associated with each one, just some of the more common ones.

Hyperkalemia - muscle weakness, cardiac dysrhythmias!!

EKG changes: tall T waves (think big K, big T!)

Causes: renal insufficiency/renal failure, metabolic acidosis, any kind of tissue injury/trauma/burns (K+ is predominantly intracellular, so when cells are damaged their contents are spewed out)

Treatment: insulin or bicarbonate to shift K+ from the ECF back into the ICF. you can also use kayexelate

Hypokalemia - muscle weakness, cardiac dysrhythmias!!

EKG changes: small T waves (think small K, small T!)

Causes: inadequate intake, potassium-wasting diuretics (thiazides and loops), vomiting/diarrhea

Treatment: give K

Hypercalcemia - "too much calcium = too calm" - you'll see muscle weakness & fatigue.

remember groans (constipation), moans (fatigue, lethargy), bones (bone pain), stones (kidney stones) and psychiatric overtones (depression & confusion) to help remember signs & symptoms.

EKG changes include a shortened QT interval.

Causes: hyperparathyroidism

Hypocalcemia is the opposite. you'll see tetany/muscle spasms, positive Chvostek's/Trousseau's signs, hyperactive DTRs, paresthesias in the fingers/extremities and around the mouth.

EKG changes include a prolonged QT interval.

Causes: hypoparathyroidism...also when a patient undergoes thyroid surgery/thyroidectomy, sometimes the parathyroid glands are accidentally removed = hypoparathyroidism.

Treatment: calcium gluconate

Hypermagnesemia

weakness, hyporeflexia (diminished or absent DTRs), cardiac dysrhythmias, respiratory depression. to help me remember hypermagnesemia, I just think of the OB patient or the patient going through ETOH withdrawal who might be getting a mag sulfate infusion and just think of what too much magnesium would equate to.

Causes: renal insufficiency, too much MgSO4

Treatment: calcium gluconate

Hypomagnesemia

muscle cramps, tremors, cardiac dysrhythmias, hyperactive DTRs, tetany...

Causes: insufficient dietary intake...you would give magnesium to correct the cause.

Treatment: give magnesium

Hypernatremia - extreme thirst, dry sticky mucous membranes, lethargy, weakness, irritability, seizures, coma (more severe)

Causes: basically not enough water...you're concentrated

Treatment: hold the sodium, give water (dilute it out)

Hyponatremia - headache, confusion, lethargy, irritability, muscle weakness...seizures, coma (more severe)

Causes: basically too much water...you're diluted! or increased loss of sodium (such as through the use of diuretics)

Treatment: hold the water, give sodium

Hello, love the way I learned the content this way. Please if you can let me know where did you take that nclex class, that would be great.

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