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Electrolyte Imbalance S/S


Does anyone have any good ideas to help remember/memorize the S/S of the imbalances of each of the electrolytes? Are there any websites that offer help with this? My head is spinning. TIA.

deeDawntee, RN

Specializes in Travel Nursing, ICU, tele, etc. Has 12 years experience.

Hello, I have been a nurse for a long time and am in the process of studying for my CCRN exam (certification for ICU nursing). So, I have been studying this material. The text books give you too much information, what I was told to concentrate on for the lyte imbalances for the CCRN exam is the neuro and cardiac signs and symptoms. Neurologically the pt will either get stimulated (seizures, twitches) or depressed (lethargy, weakness).The only ones you really need to know is Na, K, Ca, Mag and (Phosphate: just reciprocal to Ca)

I know one saying for hypocalcemia (which has same s/s as hyperphosphatemia) note: CNS stimulation.

Twitch, Twitch

Seize, Seize

Chovsteks and Trousseaus

Also hypophosphatemia corresponds with reciprocal hypercalcemia,

same s/s: weakness, apathy and mental confusion. (CNS depression)


phew that takes care of 4 of them!

Now just to learn sodium and potassium

Hypernatremia: thirst, CNS depression (this person is very dehydrated, a little old lady from a NH)

Hyponatremia: edema, seizures, irritability, muscle twitching, confusion (CNS stimulation) (this person is fluid overloaded)

(sodium doesn't have much impact on heart rhythms because it is extracellular)

Hyperkalemia: (renal failure) bradycardia, tall-peaked t waves, tremors twitching (CNS stimulation)

Hypokalemia: (too much lasix) tachycardia, hypotension, flacid muscles, flat t waves, u waves. (CNS depression) ventricular irritability

(Potassium has a profound impact on heart rhythms, this is how anorexics die, with this imbalance, any time there is GI losses, Potassium balance is altered.)


Then there was Magnesium:

Hypermagnesia (renal failure) CNS depression, hypo reflexes, brady, hypotension

Hypomagnesia CNS stimulation, irritability, increased reflexes, ventricular irritability


So, CNS depression occurs with:

hypophosphatemia and hypercalcemia

hypernatremia and hypokalemia


And the opposite for CNS stimulation:

hyperphosphatemia and hypocalcemia

(twitch, twitch, seize, seize, chvosteks and trousseaus)

hyponatremia and hyperkalemia


I hope this helps. I think if you know the CNS effects, know that potassium has lethal effects on heart rhythms. (Potassium is what they give for lethal injections to kill convicted criminals), know the twitch twitch seize seize etc for hypocalcemia (hyperphosphatemia) you will have all the information you will need.

This may be a bit oversimplified, but if you can wrap your mind around these basics you can probably figure out the right answer to most questions. The NCLEX is going to want to know if you can recognize basic signs and sxs, and that is also true for the CCRN exam.

Thanks deeDawntee! That does help make it easier to remember. Good luck to you with your CCRN exam.:up:


Specializes in Many. Has 5 years experience.

Thank you so much DeeDawntee, Im in the LVN to RN and in 3rd semester 2nd year and that helped soooo much, especially since I want to be a Flight Nurse. Thank you Thank you!!!

I know this is an old thread, but I came across it since I'm taking the NCLEX in 5 more days and am awful at remembering electrolyte imbalances. This helps immensely, thanks sooo much deeDawntee! I like that it's oversimplified! :)

Does anyone else have any ideas on how to remember electrolyte imbalances..i just cant seem to figure it out

Use the sound of these letters:

Ka- for cardiac- Calcium and Potassium effect the heart

Na- for Neuro- Sodium effects are neurological

Ma- for Muscle although Mag also effects the nerves and heart

Twitch, Twitch, Seize, Seize

Calcium and Magnesium Low (the above sort of forgot the lytes)

Chvosteks and Trouseau

This part is weird but maybe someone will catch on because all you have to remember is hypomagical and then hypermagical- from there fill in the rest, my teacher says try to think in very broad terms or it will get too confusing, my test is next week, hopefully I will be helped by this, next is the foods that go with the lytes:

hyper magical (mag and calcium) floppy (think in the clouds- write it down )

hypo netipot (Sodium and potassium) floppy

hypo magical - seizures (think on the ground and write this down first)

hyper netipot - seizures

Edited by WanderingSagehen
miss spelled word

thank you for this. I'm currently in my 4th semester and I STILL have a hard time remembering the s/s of these electrolyte imbalances. :)

Magnesium at the Zoo.

The foods you eat for magnesium are fed to the animals at the zoo:

The elephants get the peanuts (nuts)

The giraffe gets the leafy greans

The monkey gets the bananas

The kids get Reeses peanutbutter cups which covers the chocolate and peanutbutter high in mag.

I know I lost my mind.....

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