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ELECTROLYTES. Are particles that carry electrical charge and are present in blood, plasma and urine. Substances whose molecules dissociate into ions when.

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Presentation on theme: "ELECTROLYTES. Are particles that carry electrical charge and are present in blood, plasma and urine. Substances whose molecules dissociate into ions when."— Presentation transcript:

1 ELECTROLYTES

2 Are particles that carry electrical charge and are present in blood, plasma and urine. Substances whose molecules dissociate into ions when placed into water cations- positively charged e.g Na +, K +, Mg ++, Ca ++ anions – negatively charged e.g Cl -, What is an electrolyte?

3 Essential minerals necessary for nerve and muscle function Maintain body fluid balance Regulate acid base balance Electrolytes

4 Positive cations : potassium K +, sodium Na +, magnesium Mg2+, calcium 2+ Negative cations : phosphate PO4 3-, chloride Cl _ Buffer : bicarbonate HCO 3 - Types of electrolytes

5 Intracellular fluid (ICF) :- prevalent cation – K +, Mg ++ prevalent anion - PO Extracellular fluid ( ECF) :- prevalent cation – Na + prevalent anion - Cl - Distribution

6 Transmission and conduction of nerve and muscle impulse Required for repolarization of cell membrane to a resting state after an action potential Maintenance of cardiac rhythms Acid base balance Normal : mmol/l POTASSIUM or K +

7 High serum K caused by :- massive intake impaired renal secretion shift from ICF to ECF : massive cell destruction e.g brain injury, crush injury Hyperkalaemia

8 Manifestation : Weak or paralysed skeletal muscles VF or cardiac standstill Small P waves and high peaked T waves REMEMBER ALS GUIDELINES Hyperkalaemia

9 CORRECTION increase elimination ( diuretics, dialysis) Force K + from ECF to ICF by IV insulin with dextrose or sodium bicarbonate reverse membrane effects of elevated ECF K + by administrating Calcium Gluconate IV Hyperkalaemia

10 CAUSES : Kidney malfunction Diabetic ketoacidosis Gastrointestinal tract losses : vomiting, diarrhoea Mg deficiency : alcohol abuse Metabolic alkalosis HYPOKALAEMIA

11 Clinical signs / Correction Cardiac arrthymias : gradual sagging ST segment, flattening of T waves, appearance of U wave Severe muscle weakness shallow respiration : threatening respiratory function Correction : oral or IV HYPOKALAEMIA

12 Most prevalent cation in ECF Plays a major role :- ECF volume and concentration : retain body water Generation and transmission of nerve impulse pH balance Normal concentration : mmol/l SODIUM or Na +

13 Elevated serum sodium: mostly water deficit causes hyper osmolality lead to cellular dehydration Primary protection: thirst mechanism from hypothalamus Hypernatraemia

14 Clinical signs Seizures, coma leading to irreversible brain damage Correction : not with WATER !! Giving NaCl solution or with addition to dextrose: gradually reduced to avoid cerebral oedema Hypernatraemia

15 Causes: Low Na in plasma caused by liver failure, kidney failure and overhydration. Proportional to excess water :SIADH (syndrome of inappropriate anti- diuretic hormone secretion) Manifestation : nausea, vomiting, headache, confusion, lethargy, restlessness, muscle weakness, spasms, cramps, seizures, coma. Non cardiogenic pulmonary oedema. Hyponatremia

16 Correction :- Find the cause Hypervolemia : both water and sodium level high liver cirrhosis, CHF, correction :- address liver and cardiac function Euvolaemic hyponatremia: excess water but body Na + level is same Hypothoridism, steroid (glucosteroid deficiency ) Correction : water restriction Hypovolaemic hyponatraemia : both water and sodium low prolonged vomiting, severe diarrhoea, decreased oral intake, diuretic use Correction : administration of NaCl. Hyponatremia

17 2 nd most abundant cation in ICF Energy metabolism : glucose utilisation, fatty acid synthesis, muscle contraction Na + – K + pump Affects Ca ++ homeostasis Release and action of PTH Magnesium

18 Malabsorption : inflammatory bowel disease Alcoholism Following parathyrodiectomy Hypercalaemia Correction : IV MgSO4 Hypomagnesaemia

19 Block synaptic transmission : deep tendon reflexes Effect on smooth muscles : ileus and urinary retention Bradycardia and hypotension : effects on Ca ++ & K + Correction: IV Ca ++ Renal patient : dialysis Hypermagnesaemia

20 Transmission of nerve impulse Muscle contraction :Myocardial Blood clotting Formation of bones and teeth Balance controlled by : parathyroid hormone Calcitonin Vitamin D CALCIUM

21 Eating disorder Lack of parathyroid hormone Hypocalcaemia

22 Hyper parathyroid hormone Vitamin D overdose Prolonged immobilisation Hypercalcaemia

23 Decreased memory Confusion, fatigue Constipation Correction :- excretion of excess Ca ++ with loop diuretics Hydration with isotonic saline Clinical symptoms

24 Maintains acid-base status Kidney regulation Good indictors of acid-base balance Bicarbonates HCO 3 _

25 THANK YOU

26 Any questions ???


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