| 🧪 Electrolyte Abnormality |
📌 Causes |
🩺 Clinical Features |
💊 Management |
| Hyponatraemia (Low Na⁺) |
- 💧 SIADH
- 💊 Diuretics
- ❤️ Heart failure
- 🫁 Liver cirrhosis
- 🧽 Renal disease (nephrotic, CKD)
|
- 🤢 Nausea, malaise
- 🧠 Confusion, headache
- ⚡ Seizures (severe)
- Coma if rapid fall
|
- 🚱 Fluid restriction (SIADH)
- 🔍 Treat cause (e.g. stop thiazide)
- 💉 Hypertonic saline (3%) if severe or seizures - ICU setting
- ⚠️ Correct slowly (<8–10 mmol/L/24h) to avoid osmotic demyelination
|
| Hypernatraemia (High Na⁺) |
- 🚱 Dehydration
- 💧 Diabetes insipidus
- 💉 Hypertonic saline or excess sodium intake
|
- 😰 Thirst, irritability
- 🧠 Confusion, lethargy
- ⚡ Seizures, coma (severe)
|
- 💧 Oral/IV hypotonic fluids (e.g. 5% dextrose)
- ⚠️ Correct slowly (≤10 mmol/L/day) → prevent cerebral oedema
- 🔍 Treat cause (DI → desmopressin)
|
| Hypokalaemia (Low K⁺) |
- 💊 Loop/thiazide diuretics
- 🤮 Vomiting, 💩 diarrhoea
- 🧬 Hyperaldosteronism
|
- 💪 Weakness, cramps
- 📉 Arrhythmias (U waves, long QT)
- 🤢 Constipation, ileus
|
- 🍌 Oral K⁺ supplements if mild
- 💉 IV potassium (max 10 mmol/hr) if severe/symptomatic
- 🔍 Treat cause, review drugs
- ⚠️ Always recheck Mg²⁺ (hypomagnesaemia worsens hypokalaemia)
|
| Hyperkalaemia (High K⁺) |
- 🧂 Renal failure
- 💊 ACEi/ARB, spironolactone
- 🧬 Addison’s disease
|
- 💪 Weakness, paraesthesia
- 📉 Arrhythmias (tall peaked T waves, widened QRS)
|
- ❤️ Calcium gluconate → stabilises myocardium
- 💉 Insulin + glucose infusion (drives K⁺ into cells)
- 💨 Salbutamol nebuliser (temporary shift)
- 🧴 Sodium bicarbonate if acidosis
- 🩸 Dialysis if severe/refractory
|
| Hypocalcaemia (Low Ca²⁺) |
- ⬇️ Hypoparathyroidism
- ☀️ Vitamin D deficiency
- 🧽 CKD (secondary hyperparathyroidism)
|
- 🤲 Tetany, carpopedal spasm
- ⚡ Seizures
- 🔔 Chvostek’s & Trousseau’s signs
|
- 💊 Oral calcium + Vit D (mild)
- 💉 IV calcium gluconate (symptomatic/severe)
- 🔍 Correct Mg²⁺ if low
|
| Hypercalcaemia (High Ca²⁺) |
- 🦴 Primary hyperparathyroidism
- 🎗️ Malignancy (bone mets, PTHrP)
- 💊 Thiazides, lithium
|
- “Stones, bones, groans, psychiatric overtones”
- 🧠 Confusion, fatigue
- 🚽 Polyuria, polydipsia, dehydration
|
- 💧 IV saline rehydration (first-line)
- 💊 Bisphosphonates (e.g. zoledronic acid)
- 💊 Calcitonin (short-term)
- 🔍 Treat cause (e.g. resect parathyroid adenoma)
|
