Fluid & Electrolytes

Cheat Sheet

Electrolyte Function HYPER “HIGH” Hypo “low”

HYPERkalemia (over 5.0) Hypokalemia (below 3.5)
Heart - TIGHT & CONTRACTED
1ST elevation and Peaked T waves HEART - LOW & SLOW
1 Flat T waves, ST depression, & prominent U wave
2 Severe = Vfib or Cardiac Standstill! MUSCULAR - LOW & SLOW
P - Potassium 3 Hypotension, Bradycardia
Potassium
1 Decreased DTR
P - Priority! Since it.. GI TRACT - TIGHT & CONTRACTED 2 Muscle cramping
1 Diarrhea 3 Flaccid paralysis (paralyzed limbs)
3.5 - 5.0 P - Pumps the heart
& muscles
2 Hyperactive bowel sounds
NEUROMUSCULAR GI - LOW & SLOW
Decreased motility, hypoactive to absent bowel
- TIGHT & CONTRACTED
Paralysis in Extremities sounds, Constipation
Increased DTR Abdominal distention
Profound Muscle Weakness, Paralytic ileus, paralyzed intestines!
(General Feeling of heaviness) *PRIORITY* for SB0 (small bowel obstruction)

HYPERnatremia (over 145) Hyponatermia (below 135)

S - Sodium HYPERNATREMIA = BIG & BLOATED HYPONATREMIA - DEPRESSED & DEFLATED
S - Swells the body 1. SKIN
Sodium to maintain:
FLUSH ‘’Red & Rosy’’
EDEMA ‘’waterbed skin’’
NEURO = Seizures & Coma
HEART = Tachycardia, & weak thready pulses

135 - 145 • Blood Pressure LOW GRADE FEVER RESPIRATORY ARREST

2. POLYDIPSIA EXCESS THIRST
• Blood Volume 3. LATE SERIOUS SIGN
• pH balance SWOLLEN dry tongue NCLEX TIP
GI = nausea & vomiting NCLEX TIP
INCREASED muscle tone NCLEX TIP

Sodium’s sidekick HYPERchloremia (over 107) Hypochloremia (below 97) t

Chloride Maintains:
NEARLY SAME AS HIGH SODIUM NEARLY SAME AS LOW SODIUM
• Blood Pressure
97 - 107 • Blood Volume
NAUSEA & VOMITING
SWOLLEN DRY TONGUE
EXCESSIVE DIARRHEA,
VOMITING, SWEATING
• pH balance CONFUSION FEVER TEST TIP: ONLY DIFFERENCE

HYPERmagnesemia (over 2.1) Hypomagnesemia (below 1.3)

1. CARDIAC - CALM & QUIET 1. CARDIAC - BUCK WILD!

Heart block EKG: ST depression, T wave inversion
Prolonged PR intervals Torsades de pointes
Magnesium M - Magnesium
M - Mellows the
VITALS = bradycardia, hypotension
2. DEEP TENDON REFLEXES -
SEVERE = V fib
VITALS = Tachycardia

1.3 - 2.1 M - Muscles (relaxes) CALM & QUIET

Hyporeflexia - Decreased DTR
2. DEEP TENDON REFLEXES - BUCK WILD
Hyporeflexia - increased DTR
3. EYES - BUCK WILD
3. LUNGS - CALM & QUIET Abnormal eye movements (nystagmus)
Depressed shallow respirations 4. GI - BUCK WILD
3. GI - CALM & QUIET Diarhea
Hypoactive bowel sounds

HYPERcalcemia (over 10.5) Hypocalcemia (below 9.0)

SWOLLEN & SLOW - MOANS, GROANS T - Trousseau’s

Keeps the 3 Bs Strong
Calcium B - Bone
& STONES
1. CONSTIPATION
T - Twerking arm with BP cuff on
C - Chvostek’s
9.0 - 10.5 B - Blood
B - Beats (heart)
2. BONE PAIN
3. STONES Renal Calculi (kidney stones)
C - Cheek smile when touched
Diarrhea
4. DEEP TENDON REFLEXES
Decreased DTR
Circumoral tingling
Severe muscle weakness Weak bones

HYPERphosphatemia (over 4.5) Hypophosphatemia (below 3.0)

‘’LOW CALCIUM’’ BAJA CA+ Swollen & SLOW - MOAN,

1. TROUSSEAU’S SIGNS GROANS & STONES
Helps with bone & teeth 2. CHVOSTEK’S SIGNS
Phosphate formation.
Helps regulate calcium
3. DIARRHEA
4. WEAK Bs
1. CONSTIPATION
2. DECREASED DTR & SEVERE
3.0 - 4.5 Ca HIGH = Phosphate LOW Strong bones? -
WEAK! (fractures)
MUSCLE WEAKNESS
3. DECREASED HR, RR
Ca LOW = Phosphate HIGH 4. INCREASED BP
Strong blood clotting? -
WEAK! (risk for bleeding)
Strong heart beats? -
WEAK! (cardiac dysrhymias)

*Disclaimer: Values above are based on NCLEX standards, many books & hospitals will differ in their values.