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Electrolytes Defined
Which statement is the best definition of electrolytes?
Hormones created by glands of the body
Minerals that are sometimes put into drinks to replace those lost by sweating
Elements found on a periodic chart
Ions in bodily fluids that regulate metabolic processes
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Electrolytes on the Periodic Table
Find the following electrolytes on the periodic table: calcium, sodium, potassium, chlorine (chloride), and magnesium.
Sodium (Na)1Potassium (K)2Magnesium (Mg)3Calcium (Ca)4Chlorine (Cl)5
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The properties of electrolytes outlined on the periodic table give insight into how each will react within the body. Within the body, electrolytes are ions in bodily fluids that regulate or affect most metabolic processes.
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Properties of Electrolytes
When dissolved in water or bodily fluids, electrolytes will conduct diffuse suppress electrical charges. Avions Cations Pions , such as sodium (Na) and magnesium (Mg), are positively charged ions. Anions Inions Scions , such as bicarbonate (HCO3) and chloride (Cl), are negatively charged ions.
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When dissolved in water or bodily fluids, electrolytes will conduct (not diffuse or suppress) electricity. Cations (not pions or avions), such as sodium (Na) and magnesium (Mg), are positively charged ions. Anions (not scions or inions), such as bicarbonate (HCO3) and chloride (Cl), are negatively charged ions.
Electrolytes have the ability to conduct electricity and combine with other electrolytes to neutralize the charge of other ions, which makes them valuable for maintaining homeostasis.
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Predicting Sodium Level
An adult has lost water through sweating while mowing the yard in the middle of a hot summer day. Unfortunately, the person did not keep water nearby to replace what was being lost. Based on this history, which serum sodium level would most likely be found if tested?
129 mEq per liter
155 mEq per liter
144 mEq per liter
136 mEq per liter
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This person has lost a large amount of water through sweat without replacing it by drinking water. This will leave them dehydrated, increasing the concentration of sodium in the blood (serum) and fluids within the body. Since a normal serum sodium level is 135-145 mEq, it is expected that this person’s level would be higher (hypernatremia), making the correct answer 155 mEq per liter.
129 mEq per liter is below normal (hyponatremia) and would not be anticipated in this situation. 136 mEq per liter and 144 mEq per liter are within the normal range for serum sodium. A normal sodium level is not anticipated in this situation.
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Hypocalcemia
Which individuals are at risk for hypocalcemia? Select all that apply.
An individual with ill-fitting dentures
Someone experiencing an increase in serum pH
A person with decreased parathyroid hormone production
A lifeguard who spends 5 hours per day outdoors
An adolescent living with renal failure
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Causes of, or risk factors for, hypocalcemia include hypoparathyroidism, malabsorption syndrome, low serum albumin, increased serum pH (alkalosis), and renal failure (retained phosphate causes loss of calcium).
Ill-fitting dentures are not likely to lead to hypocalcemia since many of the foods that contain calcium, such as milk, yogurt, and ice cream, do not need to be chewed. Spending 5 hours outside in the sunlight promotes vitamin D synthesis, contributing to healthy calcium levels.
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Low Magnesium
A person with a low magnesium level is most likely to experience which symptoms? Select all that apply.
Tremors
Tetany
Muscle weakness
Poor reflexes
Drowsiness
Seizures
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Hypomagnesemia, or low serum magnesium, causes central nervous system irritability. This is reflected in the body by seizures, tetany, and tremors.
Drowsiness, poor reflexes, and muscle weakness are associated with hypermagnesemia.
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Chemical Combinations
Match the symbol of the electrolyte to the chemical compound and function with which it is associated.
| Symbol | Chemical Compound | Function |
| K+ | Potassium chloride | Helps regulate heart rhythm |
| H+ | Hydrochloric acid | Digestion |
| Na+ | Sodium chloride | Regulates osmotic pressure |
| Ca+ | Calcium chloride | Important for bone regulation |
| Mg+ | Magnesium chloride | Works with muscle and nerves |
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Naming Electrolyte Alterations
Using the laboratory results, select the name of the electrolyte imbalance from the drop-down menu.
| Electrolyte | Laboratory Result | Imbalance |
| Sodium (Na) | 132 mEq/L | hypercalcemia hypernatremia hyponatremia |
| Potassium (K) | 5.7 mEq/L | hyperchloremia hyperkalemia hypermagnesemia |
| Chloride (Cl) | 94 mEq/L | hypernatremia hypochloremia hypokalemia |
| Calcium (Ca) | 8.0 mg/dL | hyperphosphatemia hypocalcemia hypomagnesemia |
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| Electrolyte | Laboratory Result | Imbalance |
| Sodium (Na+) | 132 mEq/L | hyponatremia |
| Potassium (K+) | 5.7 mEq/L | hyperkalemia |
| Chloride (Cl–) | 94 mEq/L | hypochloremia |
| Calcium (Ca2+) | 8.0 mg/dL | hypocalcemia |
| Electrolyte & Abbreviation | Normal Value | Hyper | Hypo | ||
| Sodium (Na) | 135-145 mEq/L | over 145 mEq/L | under 135 mEq/L | ||
| Potassium (K) | 3.5-5.0 mEq/L | over 5.0 mEq/L | under 3.5 mEq/L | ||
| Chloride (Cl) | 98-106 mEq/L | over 106 mEq/L | under 98 mEq/L | ||
| Calcium (Ca) | 9.0-10.5 mg/dL | over 10.5 mg/dL | under 9.0 mg/dL | ||
| Magnesium (Mg) | 1.3-2.1 mEq/dL | over 2.1 mEq/dL | under 1.3 mEq/ | ||
| Phosphate (P) | 3.0-4.5 mg/dL | over 4.5 mg/dL | under 3.0 mg/dL | ||
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Electrolyte Imbalance: What Matters Most?
From the cues available, select those that provide information about this person’s health.
A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student’s caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice.
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Cues that provide information about the alteration in health include:
- muscle cramps, caused by loss of sodium in muscles
- confusion, caused by water shifting into brain cells
- headache, caused by altered nerve conduction
- continuing to drink water; water does not contain electrolytes to replace what the student has lost
The fact that the student was at band practice is not as important as having spent four hours outside on a hot, humid afternoon (which was not an option to select). The time that the student’s caregiver checked on them is not important at this time, but may be useful information should the student require healthcare later.
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Electrolyte Imbalance: What Could it Mean?
A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student’s caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice.
Based on the cues, which body systems are impacted by the student’s alteration in health? Select all that apply.
Musculoskeletal
Endocrine
Gastrointestinal
Neurological
Cardiovascular
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The confusion, lethargy, and headache are clues of alterations in the neurological system. The muscle cramps are occurring in the musculoskeletal system.
Anorexia and nausea are symptoms associated with the gastrointestinal system. Decreased blood pressure, if present, would involve the cardiovascular system. While an endocrine disorder could be the cause of the student’s symptoms, there is no information indicating that is the case.
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Electrolyte Imbalance: What is Happening?
A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student’s caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice.
Based on the cues provided, the student is most likely experiencing hyperphosphatemia hypocalcemia hyponatremia which could be confirmed by a blood microbiology test.
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Based on the cues provided, the student is most likely experiencing hyponatremia, which could be confirmed by a blood test. While the blood test is not available to be done in the home, a serum sodium level of less than 135 milliequivalents per liter (mEq/L) confirms the suspected hyponatremia.
Since the onset was rapid (hours, rather than days), the student is at high risk for life-threatening effects of low sodium, including rapid swelling of the brain which can result in seizure, coma, and death. Due to the confusion, the caregiver should seek medical attention for the student.
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Electrolyte Imbalance: How Can This be Prevented?
A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student’s caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice.
Which action by the student could have prevented them from becoming hyponatremic?
Skipped marching band practice
Drank an isotonic sports drink instead of water
Eaten a large breakfast
Taken multivitamin supplements daily
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Because water does not contain electrolytes, the student needed to replace electrolytes and fluid together. Isotonic sports drinks include electrolytes and are the best choice to prevent hyponatremia caused by excessive sweating.
As a student in the marching band, attending practice is required, so skipping is not the best option. Unless the breakfast contained a large amount of sodium, breakfast would not have made up for sodium lost through excessive sweating. Vitamin supplements rarely contain sodium because it is available in a well-balanced diet.
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Calcium
Which items should be included in the diet of a person who wants to increase their calcium intake? Select all that apply.
Green, leafy vegetables
Carbonated beverages (e.g., soda)
Milk and cheese
Vitamin D supplement
Almonds
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Calcium is found naturally in dairy products, such as milk and cheese, green, leafy vegetables, and almonds. Adding a vitamin D supplement helps the body absorb calcium in the gastrointestinal tract. The highest source of dietary calcium is from dairy products. Calcium from dairy products is most easily absorbed by the gastrointestinal system.
Carbonated beverages contain phosphate, which has a reciprocal relationship with calcium. Drinking large amounts of carbonated beverages can increase serum phosphate and decrease serum sodium.
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At Risk for Magnesium Imbalance
Which clients are at risk for hypomagnesemia due to preexisting alterations in health? Select all that apply.
Someone taking a diuretic every day
An adult with Addison’s disease
A person living with alcohol use disorder
A healthy woman in the third trimester of pregnancy
An individual with renal failure
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Conditions that place a person at high risk for hypomagnesemia include diuretic use, diabetic ketoacidosis (high blood sugar leading to ketone formation), hypoparathyroidism, malnourishment, and alcohol use disorder.
Addison’s disease and renal failure are causes of hypermagnesemia. Since the pregnant woman has no alterations in health, the pregnancy should not put her at risk for hypomagnesemia.
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Promoting Healthy Chloride Levels
A client has a serum chloride level of 190 mEq/L. Which foods should the client avoid? Select all that apply.
Tomato juice
Canned corn
Fresh carrots
Table salt
Broiled chicken
Black olives
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A chloride level of 190 mEq/L is high ( the normal adult range is 98-106 mEq/L), so the client should avoid foods high in chloride. Anything high in salt (sodium chloride) is also high in chloride. Items high in salt include:
- canned corn, unless the label indicates it is low sodium
- table salt, which is sodium chloride (NaCl)
- black olives, which are cured in brine (an 8-10% solution of NaCl and water)
- tomato juice (tomatoes are naturally high in chloride)
Fresh carrots and broiled chicken are naturally low in chloride, though seasonings and condiments that are high in chloride should be avoided during preparation and cooking.
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Dietary Sodium
A friend decided to decrease their dietary intake of sodium and is discussing the steps they are taking. Which statement made by the friend indicates they do not understand a low-sodium diet?
“I will avoid eating canned foods.”
“I will eat more fresh vegetables and fruits.”
“I will avoid cooking with salted butter.”
“I’m glad I can still eat sandwiches with bologna.”
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Because of how they are processed, many lunch meats, including baloney, are high in sodium and should be avoided. The statement “I’m glad I can still eat sandwiches with bologna.” indicates the friend does not understand a low-sodium diet.
Fresh fruits and vegetables are naturally low in sodium and can be included in the friend’s diet. Canned goods often use sodium to enhance flavor and should be avoided. Unsalted butter can be used on a low-sodium diet.
