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Electrolyte

CATIONS
Sodium
Potassium
Calcium
Magnesium
ANIONS
Chloride
Bicarbonate
Proteinates
Organic acids
Phosphates
Sulfate

Symbol

Function

Na+
K+
Ca++
Mg++

major extracellular cation; fluid balance; crystalloid osmotic pressure


major intracellular cation; neuromuscular excitability; acid-base balance
neuromuscular irritability; blood clotting; bone structure
enzyme system

ClHCO3-

major extracellular anion; fluid balance; crystalloid osmotic pressure


acid-base balance (acidosis)
colloid osmotic pressure; acid-base balance
intermediary cellular metabolism
major intracellular anion
protein metabolism

HPO4-HSO4--

ROUTINE LAB VALUES


Lytes/Cr/Prot/BS
Na
135-145 mEq/L
Cl
98-103 mEq/L
Ca
8.5-10.5mg/dl
K
3.5- 5.0 mEq/L
HCO3
24-26 mEq/L
CO2
24-35 mmol/L
BUN
5-25 mg/dl
creat
0.5-1.2 mg/dl
prot
6-8 gr/dl
glucose 60-120 mg/dl

CBC/Platelets
Hbg
12-15 gm%
Hct
36-45 %
WBC
5,000-10,000
platelets 250-350

Oxygen Saturation Levels


SpO2 pulse ox > 97%
SaO2 oxygen sat > 95%
SvO2 mixed venous = 75%

Arterial Blood Gases


pH
7.35-7.45
PaO2
85-100
PaCO2 35-45
HCO3
22-26

mOsm/kg 275-295
Mg 1.3 2.1
PTT 20-35 sec
PT 12-14 sec
INR 0.9-1.1
Hemodynamic Parameters
Alb 3.3-5.2g/dl
CO 4-6 L/min
Phos 3-4.5mg/dl
CVP 6-12 cm H20
Alk Phos 35-150
-5
SVR 900-1600 dynes/sec/cm
SGOT/AST 1-45 U/L
PVR 155-255 dynes/sec/cm-5
SGPT/ALT 1-36 U/L
PCWP = 6-10 mmHg
FSP <10g/ml

HbA1c 4-6%
Red Blood Cells
White Count Differential

Nutritional Values

Reticulocytes 0.5-1.5%

Bands/stabs
3-5%
Mean Corp Vol (MCV) 86-98
Neutrophils (Segs) 51-67%
Mean Corp Hbg (MCH) 27-32 pg
Eosinophils
1-4%
Mean Corp Hbg Conc (MCHC) 1-38%
Basophils
0-1%
ESR male 1-13, female 1-20mm/hr
Lymphocytes
25-33%
Monocytes
2-6% Urinalysis
Total % Differential 100% pH 4.5-8; negative: RBCs, WBCs, glucose/ketones
color straw, yellow; sp gr 1.005-1.025

Vit B12 205-876 pg/ml


Folate >3.3 ng/ml
Fe 50-150 mcg/dl
Ferritin 20-400 mcg/ml
Total Fe Bind Cap (TIBC) 250-410 mcg/dl
Transferrin saturation 20-50%

***Necessary values to know: WBC, platelets, RBC, hematocrit, hemoglobin, ESR, creatinine, BUN, cholesterol (total, HDL, & LDL),
glucose, hemoglobin A1C (HBA1C), sodium, potassium, magnesium, calcium, phosphate, protein, albumin, ALT (SGPT), ammonia, AST
(SGOT), bilirubin, bleeding time, PT, PTT, APTT, INR, gastric pH, urine pH and specific gravity, digoxin, lithium, O2 sat, and ABGs (pH,
PO2, PCO2, SaO2, HCO3).

IV SOLUTIONS
Isotonic / Crystalloids:
D5W, NS, RL
Hypotonic Solutions:
1/2NS, D5 1/2NS, D5 1/4NS
Hypertonic Solutions:
D5NS, D5RL, D10W, D20W, D50W 3%NS
Colloids: Dextran, Hetastarch, Plasmanate, Albumin
Blood Products: Whole Blood, Packed RBCs, Platelets, Fresh Frozen Plasma, Cryoprecipate
Total Parenteral Nutrition (TPN): Lipid Solutions, 3 in 1 Solutions

Summary of Major Electrolyte Imbalances


Electrolyte

Excess

Deficit

Sodium (Na)

Hypernatremia
Thirst
CNS deterioration
Increased interstitial fluid

Hyponatremia
CNS deterioration

Potassium (K)

Hyperkalemia
Ventricular fibrillation
ECG changes
CNS changes

Hypokalemia
Bradycardia
ECG changes
CNS changes

Calcium (Ca)

Hypercalcemia
Muscle weakness
Constipation, Bone pain
ECG changes

Hypocalcemia
Tetany, Chvosteks, Trousseaus
Muscle twitching, CNS & EKG changes

Magnesium (Mg)

Hypermagnesemia
Loss of deep tendon reflexes
Depression of CNS
Depression of neuromuscular function

Hypomagnesemia
Hyperactive DTRs
CNS changes
EKG changes

ABG Interpretation
Normal level
pH

7.35 - 7.45

PaCO2

35 - 45

HCO3

22 - 26

PaO2

80 - 100

Steps for ABG interpretation:


1. pH (acidosis or alkalosis)
Acidosis < 7.35 - 7.45 < Alkalosis
2. Respiratory component (PaCO2)
Alkalotic < 35-45 < acidotic
3. Metabolic component (HCO3)
Acidotic < 22-26 < alkalotic
4. Which component matches the pH
5. Degree of compensation
Absent: Abnormal pH & Uninvolved component within normal
Partial: Abnormal pH & Uninvolved component out of normal limits
Complete: Normal pH & Both components out of normal limits
pH

PaCO2

HCO3

nl

Hypoventilation, Respiratory failure

or nl

Long-standing respiratory insufficiency, COPD

Respiratory Alkalosis

nl

Hyperventilation

Metabolic Acidosis

Anaerobic metabolism, Lactic acidosis, Anoxia, Poisoning,


Overdose

Metabolic Alkalosis

or nl

Vomiting, Poisoning, Overdose

Respiratory Acidosis
Compensated Respiratory
Acidosis

Causes

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