Electrolyte Abnormalities. 3 July 2008 Justin A. Glass, MD Emory Family Medicine. Goals. Review of common electrolyte abnormalities Normal ranges Clinical manifestations of hypo- or hyper- states Causes Treatment options. Goals. What will spend time on today… Sodium Potassium
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3 July 2008
Justin A. Glass, MD
Emory Family Medicine
2 (Na) + Gluc / 18 + BUN /2.8
Hyperproteinemia (>10 mg / dl)
Na: 2.4 mEq / liter decrease per
100 mg/dl increase in glucose
Am J Med 1999 Apr;106(4):399-403
Need to assess volume status next in these patients.
Tx: Isotonic saline
Urine Na: < 20 mEq /liter except in CKD
Tx: Salt restriction / water restriction / diuretics
Am J Med. 2007 Nov;120(11 Suppl 1):S1-21.
D5W to replace fluid loss after diuretics
Measured Na (mEq/l) x current TBW / Normal Na
Desired TBW – current TBW
Sxs: Polyuria / Polydipsia / Low urine osm
Max Concentration: 60 mEq / liter
Note pain is common at > 40 mEq /liter
Rate: 10 mEq / hr (20 mEq / hr with tele)
Monitor response and decrease conc / rate as appropriate.
1. Give two ampules IV over 10 minutes
2. Add six ampules to 500 ml D5W and infuse
at 1 mg / kg / hr
<2% = GI loss
>2% = Renal loss