Electrolyte Imbalance Nursing Diagnosis

This article discusses Electrolyte Imbalance Nursing Diagnosis.

Introduction

Electrolyte imbalances occur when electrolyte levels become too high or too low, which is a sign of another issue in the body. The kidneys and liver help maintain electrolyte balance. Electrolyte Imbalance Nursing Diagnosis various depending with the type of disorder caused by the electrolyte imbalance.

Electrolytes are elements and compounds that occur naturally in the body. They control essential physiologic functions. Electrolytes carry either a positive or negative charge. These minerals are dissolved in your body’s fluids.

This blog post will outlines electrolyte imbalance nursing diagnosis and provides detailed description of electrolyte disorders, their respective symptoms, causes, risk factors and prevention methods. As you read, keep in mind that our professional nursing writers are ready to help with your assignment if you get stuck. All you need to do is place an order with us.

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor if you’re looking for medical advice.

Electrolytes are minerals that the body needs to:

Some of the body’s most important electrolytes are:

You can also check out What Are Electroly? List The Principal Electrolytes And Their Functions.

Types of electrolyte disorders

Elevated levels of an electrolyte are indicated with the prefix “hyper-.” Depleted levels of an electrolyte are indicated with “hypo-.”

Conditions caused by electrolyte level imbalances include:

Calcium

Calcium is a vital mineral that your body uses to stabilize blood pressure and control skeletal muscle contraction. It’s also used to build strong bones and teeth.

Hypercalcemia 

It occurs when you have too much calcium in the blood. This condition occurs when the calcium levels in your blood rise above 10.1 mg/dL.

Symptoms

You might not have signs or symptoms if your hypercalcemia is mild. More-severe cases produce signs and symptoms related to the parts of your body affected by the high calcium levels in your blood. Examples include:

Causes

Nursing Diagnosis of Hypercalcemia

Hypercalcemia is diagnosed by a serum calcium concentration > 10.4 mg/dL (> 2.60 mmol/L) or ionized serum calcium > 5.2 mg/dL (> 1.30 mmol/L). The condition is frequently discovered during routine laboratory screening.

Serum calcium can be artifactually elevated by high serum protein levels. True ionized hypercalcemia can also be masked by low serum protein.

Prevention of Hypercalcemia

Not all hypercalcemia can be prevented, but avoiding excess intake of calcium pills and calcium-based antacid tablets is recommended. Be sure to talk with your doctor if you have a family history of high calcium, kidney stones or parathyroid conditions. Avoid taking dietary supplements, vitamins or minerals without discussing them with your doctor.

Hypocalcemia 

It occurs due to a lack of adequate calcium in the bloodstream. This condition occurs when the calcium levels in your blood drop below 8.9 mg/dL.

Symptoms of Hypocalcemia

Early-stage calcium deficiency may not cause any symptoms. However, symptoms will develop as the condition progresses.

Severe symptoms of hypocalcemia include:

Causes

Nursing Diagnosis of Hypocalcemia

Hypocalcemia may be suspected in patients with characteristic neurologic manifestations or cardiac arrhythmias but often occurs incidentally. Hypocalcemia is diagnosed by a total serum calcium concentration < 8.8 mg/dL (< 2.2 mmol/L). However, because low plasma protein can lower total but not ionized, serum calcium, ionized calcium should be estimated based on albumin concentration.

Suspicion of low ionized calcium mandates its direct measurement, despite normal total serum calcium. A serum ionized calcium concentration < 4.7 mg/dL (< 1.17 mmol/L) is low.

Hypocalcemic patients should undergo measurement of renal function (e.g., BUN [blood urea nitrogen], creatinine), serum phosphate, magnesium, and alkaline phosphatase.

When no etiology is evident, further testing is needed. Additional testing begins with serum concentrations of magnesium, phosphate, parathyroid hormone, alkaline phosphatase, and occasionally vitamin D levels, both 25(OH)D and 1,25(OH)2D. Urinary phosphate and cAMP concentrations are measured when pseudohypoparathyroidism is suspected.

PTH concentration should be measured as an assay of the intact molecule. Because hypocalcemia is the significant stimulus for PTH secretion, PTH normally should be elevated in response to hypocalcemia. Thus,

Prevention of Hypocalcemia

You can prevent calcium deficiency disease by including calcium in your diet every day.

Be aware that foods high in calcium, such as dairy products, can also be high in saturated fat and trans fat. Choose low-fat or fat-free options to reduce your risk of developing high cholesterol and heart disease.

Chloride

Chloride is necessary for maintaining the proper balance of bodily fluids. It also helps make the digestive enzymes that help the body metabolize food.

Hyperchloremia 

It occurs when there’s too much chlorine in the body. This condition occurs when the chlorine levels in your blood rise above 106 mEq/L.

Symptoms

When chloride levels are moderately high, a person may not notice any symptoms. Long-term hyperchloremia, however, can cause a range of symptoms.

Those include:

Causes

Nursing Diagnosis of Hyperchloremia

Hyperchloremia is typically diagnosed by a test known as a chloride blood test. This test is usually part of a more extensive metabolic panel a doctor may order.

Normal chloride levels for adults are in the 98–107 mEq/L range. If a test shows a chloride level higher than 107 mEq/L,  hyperchloremia is positive.

Prevention

Hyperchloremia can be hard to prevent, particularly when it is caused by a medical condition such as Addison’s disease. For people who are at risk of developing hyperchloremia, some strategies that may help include:

Hypochloremia

Hypochloremia condition develops when there’s too little chloride in the body. This condition occurs when the chlorine levels in your blood drop below 96 mEq/L.

Symptoms of Hypochloremia

You often won’t notice symptoms of hypochloremia. Instead, you may have symptoms of other electrolyte imbalances or from a condition that’s causing hypochloremia.

Symptoms include:

 It’s often caused by sodium or potassium problems.

Other causes can include:

Nursing Diagnosis of Hypochloremia

The diagnosis of hypochloremia is made on the basis of the patient’s history of the disease or medication causing the imbalance, along with the lab assessment of chloride values. A chloride blood test is carried out to detect abnormal concentrations of chloride. As hypochloremia co-exists with other electrolyte imbalances such as hyponatremia and hypokalemia (low potassium), blood tests for other electrolytes are also performed to screen for various conditions. When serum chloride is less than 95 mEq/L, the patient is considered to have hypochloremia.

Prevention

You can take the following measures to avoid hypochloremia:

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Electrolyte imbalance nursing diagnosis
Electrolyte imbalance nursing diagnosis

Magnesium

Magnesium is a critical mineral that regulates many vital functions, such as:

Hypermagnesemia

Hypermagnesemia condition occurs when the chlorine levels in your blood rise above 2.5 mEq/L.

This disorder primarily affects people with Addison’s disease and end-stage kidney disease.

Symptoms

The symptoms of hypermagnesemia include:

Exceptionally high magnesium levels in the blood can lead to heart problems, difficulty breathing, and shock. In severe cases, it can result in a coma.

Causes

Most cases of hypermagnesemia occur in people who have kidney failure. Hypermagnesemia occurs because the process that keeps magnesium levels in the body at normal levels does not work correctly in people with kidney dysfunction and end-stage liver disease.

When the kidneys do not work correctly, they cannot get rid of excess magnesium, which makes the person more susceptible to a build-up of the mineral in the blood.

Some treatments for chronic kidney disease, including proton pump inhibitors, can increase the risk of hypermagnesemia. Malnourishment and alcoholism are additional risk factors in people with chronic kidney disease.

Other causes

It is rare for someone who has normal kidney function to develop hypermagnesemia. If a person with healthy kidney function does develop hypermagnesemia, the symptoms are usually mild.

Other causes of hypermagnesemia include:

Nursing Diagnosis of Hypermagnesemia

A blood test can be carried out to diagnose hypermagnesemia by measuring magnesium levels in the blood. Hypermagnesemia is diagnosed using a blood test. The level of magnesium found in the blood indicates the severity of the condition.

A normal level of magnesium is between 1.7 and 2.3 mg/dL. Anything above this and up to around 7 mg/dL can cause mild symptoms, including flushing, nausea, and headache.

Magnesium levels between 7 and 12 mg/dL can impact the heart and lungs, and levels in the upper end of this range may cause extreme fatigue and low blood pressure.

Levels above 12 mg/dL can lead to muscle paralysis and hyperventilation. When levels are above 15.6 mg/dL, the condition may result in a coma.

Prevention

People with underlying kidney issues are at risk of developing hypermagnesemia because their kidneys may not be able to excrete enough magnesium.

Avoiding medications that contain magnesium can help prevent complications. This includes some over-the-counter antacids and laxatives.

Doctors are advised to test for hypermagnesemia in anyone with underperforming kidneys who experiences the associated symptoms.

Hypomagnesemia

Hypomagnesemia condition occurs when the magnesium levels in your blood drop below 1.5 mEq/L.

Hypomagnesemia symptoms

People with mild hypomagnesemia may have no symptoms. If symptoms arise, they may include:

A more severe magnesium deficiency can cause:

Causes

You can also check out Nursing Interventions Related To Fluid Electrolyte Imbalances

 Nursing Diagnosis of Hypomagnesemia

The body contains approximately 25 grams (g)  of magnesium, more than half of which is in the bones. Magnesium is also abundant in the soft tissues. Less than 1% of the body’s magnesium is in serum, the fluid component of blood.

In the blood, normal serum magnesium levels range from 0.75 to 0.95 mmol/l . Doctors diagnose hypomagnesemia when an individual has a serum magnesium level of less than 0.75 mmol/l.

A blood test can confirm the diagnosis. Serum magnesium lower than 1.8 mg/dL is considered low. A magnesium level below 1.25 mg/dL is considered very severe hypomagnesemia.

Phosphate

The kidneys, bones, and intestines work to balance phosphate levels in the body. Phosphate is necessary for a wide variety of functions and interacts closely with calcium.

Hyperphosphatemia

This condition occurs when the phosphate levels in your blood rise above 4.5 mg/dL

Symptoms

Hyperphosphatemia does not usually have apparent symptoms. It is more likely that the symptoms of an underlying disease that can cause high phosphate levels, such as uncontrolled diabetes, are spotted first.

If levels of phosphate in the blood become too high, it may cause mineral and bone disorders and calcification.

Causes

Nursing Diagnosis of Hyperphosphatemia

Prevention

The primary way to prevent hyperphosphatemia is to control phosphate and calcium levels in the body. This is usually done by eating certain foods and avoiding others.

Processed foods often contain phosphorus as a preservative, shown by ingredients that have the letters PHOS together. A person with an underlying condition linked to hyperphosphatemia may wish to avoid these foods.

Certain natural foods, such as peas, milk, and peanut butter, also contain high levels of phosphorus.

For people with kidney disease, eating a diet with the right amount of minerals is essential for managing the condition. This can be not very easy, and a nutritionist can help to explain which foods to eat or avoid.

Hypophosphatemia

This condition occurs when the phosphate levels in your blood drop below 2.5 mg/dL.

Symptoms

Many people with mild hypophosphatemia don’t have symptoms. Symptoms may not appear until your phosphate levels drop very low.

When symptoms do occur, they can include:

Causes

Nursing Diagnosis of Hypophosphatemia

Potassium

Potassium is crucial for regulating heart function. It also helps maintain healthy nerves and muscles.

Hyperkalemia 

This condition may develop due to high levels of potassium. This condition occurs when the potassium levels in your blood rise above 5 mEq/L.

Symptoms of Hyperkalemia

Many people with mild hyperkalemia have no signs or ones that are easy to dismiss. Symptoms often come and go and may come on gradually over weeks or months. Dangerously high potassium levels affect the heart and cause a sudden onset of life-threatening problems. Hyperkalemia symptoms include:

This condition can be fatal if left undiagnosed and untreated. It’s typically triggered by:

Nursing Diagnosis of Hyperkalemia

Hyperkalemia often has no symptoms. This means doctors often find it challenging to diagnose.

In cases of acute hyperkalemia, doctors will:

In chronic hyperkalemia, doctors follow up by:

Prevention of Hyperkalemia

If you’ve had hyperkalemia or are at risk for it, a low-potassium diet is the best way to protect your health. You may need to cut back on, or completely cut out, certain high-potassium foods, such as:

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Electrolyte imbalance nursing diagnosis
Electrolyte imbalance nursing diagnosis

Hypokalemia 

It may occurs when potassium levels are too low. This condition occurs when the potassium levels in your blood drop below 3.5 mEq/L.

Symptoms of Hypokalemia

Mild cases of low potassium might not cause symptoms. More severe cases might cause:

 This often happens as a result of:

Nursing Diagnosis of Hypokalemia

A blood test is done to test for hypokalemia. A doctor will ask you about your health history. He/she may want to know if you’ve had any illness that involved vomiting or diarrhea. They’ll ask about any conditions you might have that could be causing it.

You may take a urine test so your doctor can find out if you’re losing potassium when you pee.

Since low potassium sometimes can affect your blood pressure, your doctor will check that, too. They also may want to do an electrocardiogram (EKG) if they think you may have arrhythmia. This is one of the more severe side effects and might change how your doctor chooses to treat the problem.

Treatment

You can get more potassium by taking supplements. Most of these you can take by mouth. In some cases, it’s necessary to get your potassium injected by IV. For example:

Prevention of Hypokalemia

The best prevention is taking foods that supply the body with potassium. The following is a list of some, but not all, foods that provide potassium:

Sodium

Sodium is necessary for maintaining fluid balance and is critical for normal body function. It also helps to regulate nerve function and muscle contraction.

Hypernatremia

It occurs when there’s too much sodium in the blood. It occurs when the sodium in your blood rises above 145 mEq/L. In many cases, hypernatremia is mild and doesn’t cause serious problems.

Hypernatremia  Symptoms

The main symptom of hypernatremia is excessive thirst. Other symptoms are lethargy, extreme fatigue, lack of energy, and possibly confusion.

Advanced cases may also cause muscle twitching or spasms. That’s because sodium is essential for how muscles and nerves work. With severe elevations of sodium, seizures and coma may occur.

Severe symptoms are rare and usually found only with rapid and significant rises of sodium in the blood plasma.

It can also show mild symptoms such as:

Abnormally high levels of sodium may be caused by:

Hypernatremia Risk Factors

Older adults are at an increased risk for hypernatremia. That’s because as you grow older, you’re more likely to have a decreased sense of thirst. You may also be more prone to illnesses that affect water or sodium balance.

Certain medical conditions also increase your risk for hypernatremia, including:

You can also check out Electrolyte Imbalance

Nursing Diagnosis of Hypernatremia 

In most cases, an underlying health condition, such as kidney disease or diabetes, will cause a person’s hypernatremia.

A doctor can often make a diagnosis by asking about the person’s medical history and carrying out a physical examination.

If the doctor suspects hypernatremia, they may run blood or urine tests. Both tests can show an increased presence of sodium in the blood, which can indicate hypernatremia.

Hypernatremia Prevention

Effective measures for the primary prevention of hypernatremia include:

Hyponatremia 

It occurs when the sodium in your blood falls below 135 mEq/L.

Hyponatremia Symptoms

Hyponatremia signs and symptoms may include:

Causes

Nursing Diagnosis of Hyponatremia 

In most cases, an underlying health condition, such as kidney disease or diabetes will cause a person’s hypernatremia.

If the doctor suspects hypernatremia, they may run blood or urine tests. Both tests can show an increased presence of sodium in the blood, which can indicate hypernatremia.

Hyponatremia  Risk Factors

The following factors may increase your risk of hyponatremia:

Prevention

The following measures may help you prevent hyponatremia:

Related FAQs

1. How do you assess for electrolyte imbalance in nursing?

Nursing Assessment for Risk for Electrolyte Imbalance. The following are the subjective and objective data you need to assess for a patient with a nursing diagnosis of Risk for Electrolyte Imbalance: Monitor serum electrolyte levels. The levels of electrolytes in the body can become too low or too high.

2. What do you need to know about electrolyte imbalance?

This care plan and nurse study guide focus on sodium, potassium, calcium, and magnesium imbalances. The following are the subjective and objective data you need to assess for a patient with a nursing diagnosis of Risk for Electrolyte Imbalance: Monitor serum electrolyte levels.

3. What are the fluid and electrolyte imbalance in NCLEX-RN?

Fluid and Electrolyte Imbalances: NCLEX-RN 1 Sodium. 2 Potassium. 3 Calcium. 4 Magnesium. 5 Phosphate. 6 Chloride. 7 Fluids and Fluid Imbalances.

4. What are the nursing diagnoses of fluid imbalance?

Edema— The accumulation of fluid in the tissues increases pressure in the veins and impairs circulation. The following nursing diagnoses are related to fluid imbalance: • Risk for impaired gas exchange related to inadequate intake or loss of fluid and electrolytes • Deficient knowledge [impaired] regarding the assessment of own hydration status

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