Question

Which of the following electrolyte imbalance places the patient at risk for the life threatening is it hyperkalemia and hypocalcemia, hypermagnesemia and hypernatremia, hypernatremia and hypomagnesemia, or hypophosphatemia and hyperchloremia?

Answer 1

Hyperkalemia

Abnormally elevated level of potassium in the blood. (normal= 3.5- 5.0 milliequivalents per liter(mEq/L))

Mild = 5.1-6.0 mEq/L

moderate=6.1-7.0 mEq/L

severe= > 7 mEq/L

Function

Potassium is critical for the normal functioning of the muscles, heart and the nerves.Plays a significant role in controlling the activity of smooth muscles and skeletal muscles as well as the muscles of the heart. also important for the normal transmission of electrical signals throughout the nervous system within the body.the normal level of potassium have the main role in the electrical rhythm of the heart..moderate hyperkalemia can cause rhythm changes comparing with mild hyperkalemia. And severe hyperkalemia affects electrical activity of the heart by suppressing and heart will stop to beat.

Hyperkalemia can cause paralysis of muscle during its sudden onset.

Symptoms are nausea, fatigue, muscle weakness or tingling sensation slow heartbeat and weak pulse.

Slowly rising hyperkalemia with chronic kidney failure is better tolerated than an abrupt rise of potassium. and can lead to cardiac arrest and death.

hypocalcemia

reduction of calcium level in blood is called hypocalcemia.(normal= 4.3 mEq/L )

calcium is key to the conduction of electricity in the body.It relays messages between brain and rest of the body.Muscles need calcium to move and bones need to stay strong, grow and heal.

Hypocalcemia may be the result of low calcium production or insufficient calcium circulation in the body.hypomagnesemia or vitamin d deficiency is a cause for hypocalcemia.

symptoms ;

• Muscle stiffness
• spasms
• paresthesia
• changes in mood
• memory issues
• dysphagia
• papilledema

severe hypocalcemia can cause seizures , arrhythmias, congestive heart failure.

the condition is rarely life-threatening.

HYPERMAGNESEMIA

Elevated level of magnesium in blood (> 2.6 mg/dL) major cause is kidney failure. signs and symptoms include hyporeflexia , hypotension, respiratory depression and cardiac arrest.

HYPERNATREMIA

It occurs when serum sodium level reaches above 145 mEq/L.

It is mainly caused by dehydration, symptoms include thirst, confusion, seizures and coma.

HYPOMAGNESEMIA

when serum magnesium level is below 1.8mg/dL.

Inadequate intake and absorption of magnesium or increased excretion due to the action of diuretic medication lead to hypomagnesemia.Hypokalemia and hypocalcemia sometimes accompanied by hypomagnesemia. Other symptoms are lethargy, tremor, tetany, seizure, and arrhythmias.

HYPOPHOSPHATEMIA

Hypophosphatemia is a serum phosphate concentration <2.5 mg/dl. causes include alcoholism, burns, starvation, and use of diuretics. Clinical features are muscle weakness respiratory failure, and heart failure.seizures and coma.severe cases may lead to death.

HYPERCHLOREMIA

An elevated level of chloride in serum, above 107 mEq/ L.It may be caused by diabetes or severe dehydration, which can affect the ability of the kidney to maintain chloride balance. symptoms include fatigue, muscle weakness, excessive thirst, dry mucous membrane, high blood pressure. it can lead to kidney stones, heart problems, muscle problems, bone problems, coma and death.

Thus, the electrolyte imbalance of hypophosphatemia and hyperchloremia are life-threatening in comparing with others.

hyperkalemia and hypermagnesemia leads to cardiac arrest.