Electrolyte+Imbalances

//Electrolytes, or ions, are the charged particles in body fluids that help transmit electrical impulses for proper nerve, heart, and muscle function. The number of positive ions, called cations, and negative ions, called anions, is supposed to be equal. Anything that upsets this balance can have life-threatening consequences. //
 * //Fluid and Electrolyte Imbalance //**

//Maintaining the right balance of electrolytes is essential in maintain homeostasis. // //Fluid and electrolyte imbalances occur in most patients with a serious illness or injury because illness disturbs the normal homeostatic mechanism. Sometimes these imbalances are caused by illness but they can also be secondary to treatment of illness // //Sodium, calcium, potassium, chlorine, phosphate and magnesium are all electrolytes however ////problems ////most often occur with changes in levels of sodium, potassium or calcium. //  
 * //Common Complications for Cancer patients related to Electrolyte Imbalances //**
 * //Hypercalcemia //**
 * Polyuria/ polydipsia
 * Stomach Pain
 * Anorexia
 * Constipation
 * Acute CNS changes
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Lethargy
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Paranoia
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Confusion
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Depression
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Somnolence to coma
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Treatment of Hypercalcemia //**
 * <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">Promotion of excretion of calcium in the urine by administration of loop diuretic( Lasix)
 * <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">Administer Isotonic Saline Infusions
 * <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">Push fluids 3000 to 4000ml of fluids per day to promote renal excretion of calcium and decrease risk of kidney stones
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Hypocalcemia //**
 * Hypocalcemia** based on total calcium measurement is frequent in certain cancers (especially prostate and hematologic cancers) in association with osteosclerotic bone metastases. In a majority of these patients hypocalcemia is related to the low serum albumin and/or renal failure. True ionized hypocalcemia may be seen as a toxic effect of certain chemotherapeutic agents or as a consequence of hyperphosphatemia due to rapid tumor lysis

<span style="font-family: Arial,sans-serif;"> <span style="font-family: 'Times New Roman',serif;"> **//<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Hyponaturemia Symptoms //**
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Acute CNS Changes
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Lethargy
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Confusion
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Depression
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Seizures
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Dry Skin
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Low Blood Pressure
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Tingling in fingers and toes
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Muscle spasms / aches
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Difficulty breathing
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">Vision changes
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Treatment of Hypocalcemia //**
 * <span style="font-family: Arial,sans-serif; font-size: 16px;">Oral or IV Calcium Supplemnts
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Nausea and vomiting
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Headache
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Confusion
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Loss of energy
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Fatigue
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Restlessness and irritability
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Muscle weakness, spasms <span style="font-family: Arial,sans-serif; font-size: 12pt;"> or cramps
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">seizures
 * <span style="font-family: Arial,sans-serif; font-size: 12pt;">somnolence to coma
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Treatment of Hyponaturemia //**
 * Fluid replacement with sodium containing solutions

<span style="background-color: #ffffff; display: block; font-family: arial,helvetica,clean,sans-serif; text-align: left;">**Hyperkalemia** is occasionally induced by chemotherapy for very large malignant tumors, due to tumor lysis syndrome. <span style="font-family: Arial,sans-serif;">
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Hyperkalemia //**
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Symptom //**
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Abnormal heartbeat
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Weak or absent pulse
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Muscle weakness
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Nausea
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: 12pt;">Fatigue
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Treatment of Hyperkalemia //**
 * <span style="color: #231f20; font-family: Arial,sans-serif; font-size: medium;">Eliminate Oral and Parenteral potassium intake
 * <span style="font-family: Arial,sans-serif;">Educate/ provide list of potassium containing foods
 * <span style="font-family: Arial,sans-serif;">Increase elimination of Potassium via, diuretic, dialysis, kayexalate
 * <span style="font-family: Arial,sans-serif;">Increase fluid intake
 * <span style="font-family: Arial,sans-serif;">Drug therapy( Insulin, epinephrine,)
 * Calcium Gluconate

<span style="font-family: 'Times New Roman',serif;">
 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Client Education and General Treatment //**
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; text-indent: 0.5in;">Drug and diet protocols specific to imbalance
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">General
 * Maintain fluid intake
 * - Take nutritional supplements as prescribed
 * Administer antiemetics prior to surgery
 * Regularly monitor lab values
 * Monitor for diarrhea, constipation, nausea, vomiting
 * Monitor dietary intake

<span style="font-family: 'Times New Roman',serif;"> **//References//** [] http://www.mayoclinic.com/health/DiseasesIndex/DiseasesIndex Medical-Surgical Nursing: Assessment and Management of Clinical Problems 7th edition, Lewis 2007

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">** Oncologic Emergencies: Diagnosis and Treatment ** <span style="color: #1e1f20; font-family: 'Times New Roman',Times,serif; font-size: 120%;"> SYMPOSIUM ON ONCOLOGY PRACTICE: HEMATOLOGICAL MALIGNANCIES <span style="color: #1e1f20; font-family: 'Times New Roman',Times,serif; font-size: 120%;">THORVARDUR R. HALFDANARSON, MD; WILLIAM J. HOGAN, MBBCH; AND TIMOTHY J. MOYNIHAN, MD.


 * //<span style="color: #0070c0; font-family: 'Times New Roman',serif; font-size: 20pt;">Additional Resources //**

Glauser, MD, Jonathan. "Oncologic Emergencies." Emergency Medicine Reports 30.8 (2009): 90-99. Www.emreports.com. Web.

http://www.cancer.org/Treatment/UnderstandingYourDiagnosis/ExamsandTestDescriptions/understanding-your-lab-test-results

http://www.caring4cancer.com/go/cancer/effects/lesscommon/electrolyte-imbalance.htm

http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=158213