Contributing Factors: Excessive sodium chloride infusions with water loss, head inury (sodium retention), hypernatremia, renal failure, corticosteroid use, dehydration, severe diarrhea (loss of bicarbonate), respiratory alkalosis, administration of diuretics, overdose of salicylates, Kayexalate, acetazolamide, phenylbutazone and ammonium chloride use, hyperparathyroidism, metabolic acidosis. Read More »
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Contributing Factors: Addison’s disease, reduced chloride intake or absorption, untreated diabetic ketoacidosis, chronic respiratory acidosis, excessive sweating, vomiting, gastric suction, diarrhea, sodium and potassium deficiency, metabolic alkalosis; loop, osmotic, or thiazide diuretic use; overuse of bicarbonate, rapid removal of ascitic fluid with a high sodium content, intravenous fluids that lack chloride (dextrose and water), draining fistulas and ileostomies, heart failure, cystic fibrosis. Read More »
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Contributing Factors: Acute and chronic renal failure, excessive intake of phosphorus, vitamin D excess, respiratory acidosis, hypoparathyroidism, volume depletion, leukemia/lymphoma treated with cytotoxi agents, increased tissue breakdown, rhabdomyolysis. Read More »
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Contributing Factors: Refeeding after starvation, alcohol withdrawal, diabetic ketoacidosis, respiratory alkalosis, decreased magnesium, decreased potassium, hyperparathyroidism, vomiting, diarrhea, hyperventilation, vitamin D deficiency associated with malabsorptive disorders, burns, acid-base disorders, parenteral nutrition, and diuretic and antacid use. Read More »
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Contributing Factors: Oliguric phase of renal failure (particularly when magnesium-containing medications are administered), adrenal insufficiency, excessive IV magnesium administration, DKA and hypothyroidism. Read More »
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Contributing Factors: Chronic alcoholism, hyperparathyroidism, hyperaldosteronism, diuretic phase of renal failure, malabsorptive disorders, diabetic ketoacidosis, refeeding after starvation, parenteral nutrition, chronic laxative use, diarrhea, acute myocardial infarction, heart failure, decreased serum K and Ca and certain pharmacologic agents (such as gentamicin, cisplatin, and cyclosporine) Read More »
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Contributing Factors: Hyperparathyroidism, malignant neoplastic disease, prolonged immobilization, overuse of calcium supplements, vitamin D excess, oliguric phase of renal failure, acidosis, corticosteroid therapy, thiazide diuretic use, increased parathyroid hormone, and digoxin toxicity. Read More »
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Contributing Factors: Hypoparathyroidism (may follow thyroid surgery or radical neck dissection), malabsorption, pancreatitis, alkalosis, vitamin D deficiency, massive subcutaneous infection, generalized peritonitis, massive transfusion of citrated blood, chronic diarrhea, decreased parathyroid hormone, diuretic phase of renal failure, increased PO4, fistulas, burns. Read More »
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Contributing Factors: Pseudohyperkalemia, oliguric renal failure, use of potassium-conserving diuretics in patients with renal insufficiency, metabolic acidosis, Addison’s disease, crush injury, burns, stored bank blood transfusion, and rapid IV administration of potassium. Read More »
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Contributing Factors: Diarrhea, vomiting, gastric suction, corticosteroid administration, hyperaldosteronism, amphotericin B, bulimia, osmotic diuresis, alkalosis, starvation, diuretics, and digoxin toxicity. Read More »
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Contributing Factors: Water deprivation in patients unable to drink at will, hypertonic tube feedings without adequate water supplementation, diabetes insipidus, heatstroke, hyperventilation, water diarrhea, burns, and diaphoresis. Excess corticosteroid, sodium bicarbonate, and sodium chloride administration, and salt water near-drowning victims. Read More »
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Contributing Factors: Loss of sodium, as in use of diuretics, loss of GI fluids, renal disease, and adrenal insufficiency. Gain of water, as in excessive administration of D5W and water supplements for patients receiving hypotonic tube feedings; disease states associated with SIADH such as head trauma and oat-cell lung tumor; medication associated with water retention (oxytocin and certain tranquilizers); and psychogenic polydipsia. Hyperglycemia and heart failure cause a loss of sodium. Read More »
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Contributing Factors: Compromised regulatory mechanisms, such as renal failure, heart failure, and cirrhosis; overzealous administration of sodium-containing fluids; and fluid shifts (i.e. treatment of burns). Prolonged corticosteroid therapy, severe stress, and hyperaldosteronism augment fluid volume excess. Read More »
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Contributing Factors: Loss of water and electrolytes, as in vomiting, diarrhea, fistulas, fever, excess sweating, burn, blood loss, gastrointestinal suction, and third-space fluid shifts; and decreased intake as in anorexia, nausea, and inability to gain access to fluid. Diabetes insipidus and uncontrolled diabetes mellitus also contribute to a depletion of extracellular fluid volume. Read More »
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