Final Group assignment Electrolytes Tests.pptx
- 1. Salale University College of Health Sciences Department of Adult Health Nursing Group Assignment: Electrolyte Tests and their clinical significance Submitted to Dr.Desie A. (PHD) June 2/06/ 2023 Fiche
- 2. Name of group member 1.Kedir Mohammed ID:182/15 2.Shambel Debele ID:190/15 3.Dereje Ayele ID:179/15 4.Nigussie Wondimu ID:188/15
- 3. Objectives To understand the components of electrolyte To understand the significance of each components of electrolyte To appreciate normal and abnormal range of electrolyte To understand the principles of fluid prescription; To appreciate methods of diagnosis and monitoring
- 4. INTRODUCTION • Electrolytes are charged particles (ions) dissolved in the various fluid compartments of the body (intravascular, interstitial, and intracellular) and perform a variety of functions in the human body. • a substance whose components dissociate in solution into positively (cation) and negatively (anion) charged ions. For example, Sodium Chloride, in solution dissociates into Na+ and Cl- Other electrolytes of physiological importance include Ca2+,Mg2+, K+, PO42-, etc
- 5. Intr... • Electrolytes are salts and minerals, such as sodium, potassium, chloride and bicarbonate, which are found in the blood. They can conduct electrical impulses in the body. • Electrolytes are chemicals that conduct electricity when mixed with water. • Minerals and salts: electrolytes • Cations: Positively charged; sodium, potassium, calcium, magnesium Major cation in ECF is sodium • Anions: Negatively charged; chloride, bicarbonate, sulfate
- 6. Basic Components of Electrolyte • The electrolytes in human bodies include: • sodium • potassium • calcium • bicarbonate • magnesium • chloride • phosphate
- 7. What is an electrolyte test used for This test may be done: • As a part of your routine health check up • To detect abnormal level of electrolytes in blood • To detect an acid-base imbalance in body. • To detect any related kidney disease. • To monitor treatment response in patients who are suffering hypertension or kidney disease(such as diuretics or ACE inhibitors, which are often used to treat high blood pressure.) • To monitor patients who are undergoing treatment like dialysis
- 8. Why is electrolyte test performed This test is advised in the following conditions: • Chronic kidney disease • Cancer treatment • Liver disease • Malnutrition • Lung disorder • Heart disease • Diarrhoea • Vomiting • Diabetes and Nerve damage
- 9. What are the signs of low electrolytes? Symptoms of low electrolytes include: Irritation Laziness and Tiredness Vomiting,Constipation or diarrhoea Muscle cramps and Weak muscles A stomach ache and Cramps in the abdomen Rapid heartbeat and Anxiety Tingling and numbness Seizures or convulsions
- 10. Which patient is more at risk for an electrolyte imbalance? • Alcoholism • Chronic liver disease • Heart failure • A kidney-related condition • Disorders of the thyroid gland • Disorders of the adrenal gland • Burns or broken bones that can cause trauma • Anorexia, bulimia, and other eating disorders
- 11. How should I prepare for an electrolyte blood test? These steps can help a blood draw go smoothly: Stay hydrated: Drink plenty of fluids before the test to help blood flow easier through blood vessels. Avoid nicotine: Don’t smoke (including vaping) before a blood draw. Nicotine constricts blood vessels, making it more difficult to insert the needle into a vein. Speak up: Let your provider know if you have a fear of needles (trypanophobia) or a fear of blood (hemophobia). There are steps they can take to make the blood draw easier for you.
- 12. Diagnosing an Electrolyte Imbalance There are several types of tests that can be used to diagnose electrolyte imbalance. Each type of test has its own pros and cons for detecting various types of imbalances. Here are just a few of the ways practitioners test for electrolyte dysfunction: The Anion Gap Blood Test is a blood test that analyses the levels of acid in the blood. This can indicate an electrolyte imbalance, as one of the functions of electrolytes is balancing the pH of the blood. Chloride Tests measure the levels of chloride, another electrolyte, in the blood. Sodium Blood Tests analyse sodium levels in the blood, another common portion of an electrolyte blood panel. Aldosterone blood test. This test looks for a specific hormone produced by your kidneys. The results can indicate certain types of electrolyte problems. Blood osmolality test. This test measures the amount of certain substances in your body. It’s frequently used in cases where you’re dehydrated, overhydrated, or when poisoning is possible or suspected.
- 13. Diagnosing an Electrolyte Imbalance Antidiuretic hormone test (blood). This test looks for levels of antidiuretic hormone. It can help rule out certain medical conditions that share symptoms — especially excessive thirst or fluid imbalance — with electrolyte-based conditions. Chloride blood test. This test analyzes a blood sample for the level of chloride found in your blood. Chloride urine test. This test measures the amount of chloride in a urine sample. In some cases, it can involve several samples taken over a 24-hour period. Magnesium blood test. This test analyzes levels of magnesium in your blood. Urine concentration test. This test shows healthcare providers how well your kidneys are functioning, especially their ability to manage the amount of fluid in your body. Phosphorus blood test. This test measures the amount of phosphorus in your blood. Phosphorus urine test. This test measures the amount of phosphorus that’s found in your urine. It may involve more than one sample taken over a 24-hour period.
- 14. Sodium • Sodium is the most abundant cation (90% of the electrolyte fluid) and the chief base of the blood. • Its primary functions in the body are to maintain osmotic pressure and acid-base balance chemically and to transmit nerve impulses. • Determinations of plasma sodium levels detect changes in water balance rather than sodium balance. Sodium levels are used to determine electrolytes, acid-base balance, water balance, water intoxication, and dehydration.
- 15. Na... Normal Range • Adults: 136–145 mEq/L (136–145 mmol/L) • Children (1–16 years): 136–145 mEq/L (136–145 mmol/L) • Full-term infants: 133–142 mEq/L (133–142 mmol/L) • Premature infants: 132–140 mEq/L (132–140 mmol/L) Values Above Reference Range : Hypernatremia Due to ↑ Na + or ↓ water Common Causes Hypernatremia may be due to: 1. excess loss of water due to vomiting, diarrhoea, severe burn,sweating, Strenuous exercise, Polyuria, Decreased intake and Osmotic diuresis 2. increased sodium retention, or 3. increased intake of sodium (salt).
- 16. Na... • Clinical features of hypernatraemia may include: fever, irritability, drowsiness, irritability, lethargy and confusion. • Lab Tests: Basic metabolic panel, including glucose, creatinine; serum and urine osmolarity, urine Na Values Below Reference Range : Hyponatremia • Common Causes Hyponatremia may be due to: (1) increased loss of sodium due to Diarrhea,Vomiting, Renal disease ,Diabetes mellitus (2) the result of water excess (dilutional) or (3) decreased intake of sodium. (4) due to cardiac or renal or hepatic failure. (5) other some medicines
- 17. Calcium The bulk of body calcium 99% is stored in the skeleton and teeth, which act as huge reservoirs for maintaining blood levels of calcium. About 50% of blood calcium is ionized; the rest is protein bound. Only ionized calcium can be used by the body in such vital processes as muscular contraction, cardiac function, transmission of nerve impulses, and blood clotting. The amount of protein in the blood also affects calcium levels because 50% of blood calcium is protein bound.
- 18. Ca+2... Measurements of ionized calcium are done during open heart surgeries, liver transplantations, and other operations in which large volumes of blood anti coagulated with citrate are given. These tests are also used to monitor renal disease, renal transplantation and hemodialysis, hyperparathyroidism and hypoparathyroidism pancreatitis, and malignancy. calcitonin, vitamin D, estrogens, androgens, carbohydrates
- 19. Normal Values for Calcium
- 20. Ca+2... Hypocalcaemia : low serum calcium levels in the blood. Caused by: parathyroid disease, vitamin D deficiency, septic shock and acute pancreatitis. Some symptoms include : tetany (involuntary muscle contraction), mental changes and decreased cardiac output. Labs : Serum Ca++ below 4.5 mEq/L, ECG abnormalities Hypercalcaemia : elevated levels of calcium in the blood, Causes Excessive use of antacids with phosphate-binding Prolonged immobility, Excessive vitamin D intake Thiazide diuretics, Cancer, Thyrotoxicosis Labs : sSerum Ca++ above 5.5 mEq/L,X-rays showing osteoporosis, Stones & BUN / creatinine fr. FVD
- 21. Chloride Chloride, a blood electrolyte, is the major anion that exists predominantly in the extracellular spaces. It maintains cellular integrity through its influence on osmotic pressure. It is also significant in monitoring acidbase balance and water balance. It has the reciprocal power of increasing or decreasing in concentration in response to concentrations of other anions. In metabolic acidosis, there is a reciprocal rise in chloride concentration when the bicarbonate concentration drops. Chloride concentration is directly proportional to sodium and inversely proportional to bicarbonate concentration.
- 22. Cl-... Because of the relatively high chloride concentrations in gastric juices, prolonged vomiting may lead to considerable chloride loss and lowered serum chloride levels. Normal Range Adults: 96–106 mEq/L or 96–106 mmol/L Newborns: 96–113 mEq/L or 96–113 mmol/L
- 23. Cl-... Hypochloremia : Values Below Reference Range Common Causes Diuretics (e.g., furosemide or thiazide) Gastric vomiting and severe diarrhea Hypoadrenocorticism Metabolic alkalosis and Respiratory acidosis Salt-losing nephropathy severe burns, fever and acute infections Lab Tests: Basic metabolic panel, including glucose and creatinine
- 24. Cl-... • Hyperchloremia : Values Above Reference Range Common Causes : Dehydration ,Diabetes insipidus , DM,Fluid therapy (hypertonic saline), Metabolic acidosis,hyperventilation, eclampsia, anemia, diarrhea Lab Tests: Basic metabolic panel, including glucose, creatinine; consider LFTs (albumin), Serum anion gap
- 25. Phosphorus The human body’s total phosphorus content, 85% is combined with calcium in the bone and the remainder resides within the cells. Most of the phosphorus in the blood exists as phosphates or esters. Phosphate is used for generation of bony tissue and functions in the metabolism of glucose and lipids, in the maintenance of acid-base balance, and in the storage and transfer of energy from one site in the body to another.
- 26. Po4-.... An excess of one electrolyte in serum causes the kidneys to excrete the other electrolyte. As with calcium, the controlling factor is PTH. Normal Range Adults: 2.7–4.5 mg/dL or 0.87–1.45 mmol/L. Children: 4.5–5.5 mg/dL or 1.45–1.78 mmol/L. Newborns: 4.5–9.0 mg/dL or 1.45–2.91 mmol/L.
- 27. Po4- hypophosphataemia : when levels of phosphate in the blood are below the normal range. caused by : vitamin D deficiency, hyperparathyroidism, oralcoholism. symptoms : generally include muscle weakness, heart. failure, seizure, and coma. Hyperphosphataemia : when levels of phosphate in the blood are above the normal range(4.5 mg/dL) caused by kidney disease, parathyroid issues, and metabolic or respiratory acidosis. Symptoms are usually not present, Renal patients can experience hardened calcium deposits when this condition goes untreated.
- 28. Magnesium Magnesium in the body is concentrated 40% to 60% in the bone, 20% in muscle, 30% within the cell itself, and 1% in the serum and is required for the use of adenosine triphosphate (ATP) as a source of energy. Mg2+ plays role in : carbohydrate and protein metabolism, storage intracellular energy and neural transmission DNA synthesis Also Important in the functioning of the heart, nerves, and muscles.
- 29. Mg+2... Magnesium deficiency will result in the drift of calcium out of the bones, possibly resulting in abnormal calcification in the aorta and the kidney. This condition responds to administration of magnesium salts. When there is decreased kidney function, greater amounts of magnesium are retained, resulting in increased blood serum levels. Magnesium measurement is used to evaluate renal function, electrolyte status, and evaluate magnesium metabolism.
- 30. Mg+2... Normal Range • Adults: 1.8–2.6 mg/dL /0.74–1.07 mmol/L. • Children: 1.7–2.1 mg/dL /0.70–0.86 mmol/L. • Newborns: 1.5–2.2 mg/dL /0.62–0.91 mmol/L. Hypomagnesaemia : a decreased plasma magnesium level. caused by decreased intake or increased loss of magnesium. Clinical signs include confusion, irritability, delirium, muscle tremors and tachyarrhythmias. Diagnostic Tests: Serum Mg, Total Protein, Serum K, Ca and Phos levels
- 31. Mg+2... Hypermagnesaemia is when the level of magnesium in the blood is above the normal range. • Symptoms include poor reflexes, low blood pressure, respiratory depression, and cardiac arrest.
- 32. Potassium Potassium is the principal electrolyte of intracellular fluid and the primary buffer within the cell itself. 90% of potassium is concentrated within the cell; only small amounts are contained in bone and blood. Damaged cells release potassium into the blood. Major intracellular cation Normally, 80% to 90% of the cells’ potassium is excreted in the urine by the glomeruli of the kidneys; the remainder is excreted in sweat and in the stool.
- 33. K... Potassium plays an important role in nerve conduction, muscle function, acid-base balance, and osmotic pressure. potassium controls the rate and force of contraction of the heart and the cardiacoutput Normal Range Adults: 3.5–5.2 mEq/L /3.5–5.2 mmol/L. Children (1–18 years): 3.4–4.7 mEq/L /3.4–4.7 mmol/L. Infants: 7 days–1 year: 4.1–5.3 mEq/L /4.1–5.3 mmol/L. Neonates (0–7 days): 3.7–5.9 mEq/L /3.7–5.9 mmol/L.
- 34. K... Hypokalaemia is defined as a serum potassium less than 3.5 mmol/L. may be caused by : decreased oral intake, increased renal or gastrointestinal loss of potassium, or a shift of potassium within the body’s fluid compartments Common clinical features of hypokalaemia range from muscle weakness and ileus (lack of peristalsis), to serious cardiac arrhythmias such as ventricular tachycardias. Tests: Basic metabolic panel, including glucose, creatinine, Mg, urine K, ECG
- 35. K... Hyperkalaemia, a serum potassium greater than 5.0 mmol/L caused by: excessive intake, tissue damage from burns or trauma, medicines such as potassium sparing diuretics, and most renal failure,Urethral obstruction/rupture , Uroperitoneum. Clinical signs of hyperkalaemia include: muscle weakness, hypotension, bradycardia and loss of cardiac output, and ECG changes
- 36. K... Labs for Hyperkalemia • Serum K+ above 5.0 mEq/L. • ECG abnormalities – can lead to arrest (if too high or too low) • Lab Tests: Basic metabolic panel, including glucose, creatinine
- 37. Bicarbonate (HCO3) Bicarbonate, which helps maintain the body's acid and base balance. It also plays an important role in moving carbon dioxide through the bloodstream. normal range: 22 to 30 mmol/L. Major body buffer Found in both ICF, ECF
- 39. REFERENCES • Laboratory and Diagnostic TestsA MANUAL OF NINTH EDITION