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    ELECTROLYTES (Na & K)

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    Alondra Sagario
    Electrolytes like sodium, potassium, and chloride are essential for maintaining osmotic pressure, hydration, acid-base balance, and various enzyme reactions in the body. Sodium is the major determinant of plasma osmolality and helps regulate water balance and blood volume. Abnormal levels of electrolytes can indicate conditions like dehydration, ketoacidosis, poisoning, or hyponatremia. Laboratory tests measure electrolyte levels using techniques like flame photometry, ion-selective electrodes, and colorimetric methods. Care must be taken to avoid artifacts that could falsely alter electrolyte results.

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    ELECTROLYTES (Na & K)

    Uploaded by

    Alondra Sagario
    37 views3 pages
    Electrolytes like sodium, potassium, and chloride are essential for maintaining osmotic pressure, hydration, acid-base balance, and various enzyme reactions in the body. Sodium is the major determinant of plasma osmolality and helps regulate water balance and blood volume. Abnormal levels of electrolytes can indicate conditions like dehydration, ketoacidosis, poisoning, or hyponatremia. Laboratory tests measure electrolyte levels using techniques like flame photometry, ion-selective electrodes, and colorimetric methods. Care must be taken to avoid artifacts that could falsely alter electrolyte results.

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    Electrolytes like sodium, potassium, and chloride are essential for maintaining osmotic pressure, hydration, acid-base balance, and various enzyme reactions in the body. Sodium is the major determinant of plasma osmolality and helps regulate water balance and blood volume. Abnormal levels of electrolytes can indicate conditions like dehydration, ketoacidosis, poisoning, or hyponatremia. Laboratory tests measure electrolyte levels using techniques like flame photometry, ion-selective electrodes, and colorimetric methods. Care must be taken to avoid artifacts that could falsely alter electrolyte results.

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    Download as docx, pdf, or txt
    37 views3 pages

    ELECTROLYTES (Na & K)

    Uploaded by

    Alondra Sagario
    Electrolytes like sodium, potassium, and chloride are essential for maintaining osmotic pressure, hydration, acid-base balance, and various enzyme reactions in the body. Sodium is the major determinant of plasma osmolality and helps regulate water balance and blood volume. Abnormal levels of electrolytes can indicate conditions like dehydration, ketoacidosis, poisoning, or hyponatremia. Laboratory tests measure electrolyte levels using techniques like flame photometry, ion-selective electrodes, and colorimetric methods. Care must be taken to avoid artifacts that could falsely alter electrolyte results.

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    ELECTROLYTES CTTO: Toprank Review Academy

    MAJOR DETERMINANT OF PLASMA OSMOLALITY= SODIUM


    OSMOLALITY:
    - determined by particle number not the nature or weight of the solute
    - measure specific gravity in urine to measure osmolality

    Clinical Significance of Osmolality


    1.Osmolality affects plasma Sodium concentration (Sodium is regulated by water balance)
    2.Osmolality of blood volume (Blood volume is regulated by Sodium balance)

    Reference Ranges for Osmolality


    Serum 275-295 mOsm/kg
    Uriine (24 hrs) 300-900 mOsm/kg
    Urine/Serum ratio 1.0-3.0
    Random Urine 50-1200 mOsm/kg
    Osmolal Gap 5-10 mOsm/kg
    Plasma Not applicable (containes Anticoagulant)

    Determination of Osmolality:
    Specimen: Serume, Urine
    Principle: Increase Osmolality = Decrease freezing point and Vapor pressure
    Osmometer: Operate by freezing point depression using standardized using sodium chloride
    reference solutions.
    (Note: Increase pure water loss = increase ECF osmolality)
    OSMOLAL GAP = Measured Osmolality - Calculated Osmolality
    Normal Moderately Elevated Markedly elevated Hypoosmolality
    Dehydration Ketoacidosis Poisoning with: Hyponatremia
    Hyperglycemia w/o Renal Acidosis -Ethanol
    ketoacidosis Lactic Acidosis -Methanol
    Hypernatremia -Isopropanol
    Azotemia -Ehtylene glycol
    Diabetes insipidus -Diethyl ether
    -Paraldehyde
    -Trichloroethane
    -Salicylate

    Primary Cations Sodium, Potassium, Calcium, Magnesium


    Primary Anions Chloride, Bicarbonate, Phosphate, Sulfate

    FUNCTIONS OF ELECTROLYTES:
    -Maintenance of Osmotic pressure and hydrations/volume regulation: Na, K, Cl
    -Buffering functions/Acid-base Balance: HCO3, K, Cl
    -Cofactors/Activators in enzyme reactions: Ca, Mg, Zinc
    -Normal neuromuscular excitability: Ca, K, Mg
    -Redox reaction/Electron transport: Iron
    -Myocardial rhythm and contractility: K, Mg, Ca
    -Regulation of ATPase ion pumps: Mg
    -Blood coagulation: Ca, Mg
    -Production of ATP from glucose: Mg, Phosphate

    ANION GAP
    -difference between the sum of the concentrations of the principal/unmeasured cations
    and of the principal/unmeasured anions
    -Represents the unmeasured net negative charge on plasma proteins
    -Useful in: Detecting errors in analysis
    (From HENRY’s)
    *HAGMA (High Anion Gap Metabolic Acidosis): MUDPILES
    (Methanol, Uremia, Diabetic Ketoacidosis, Propylene glycol, Iron, Lactic Acidosis, Ethylene glycol,
    Salicylates)
    *NAGMA (Normal Anion Gap Metabolic Acidosis: Diarrhea, RTA, Addison’s dse
    *LAP (Low Anion Gap): Hypoalbuminemia, Hypercalcemia, Elevated Myeloma proteins

    SODIUM
    -most adversely affected by improper type of water used
    -MOST ABUNDAT CATION IN THE ECF/CHIEF BASE OF THE BLOOD
    -Main function are water pull
    -Osmotic activity of ECF
    -Blood volume regulation
    -Neuromuscular Excitability
    -Levels are regulated by:
    -ADH (Water retention) = Dilutional Hyponatremia
    - Aldosterone = Increasedd Na reabsorption
    - Atrial natriuretic factor = decreases Na reabsorption in the DCT
    -Normal value
    -Kidney: Renal threshold for Na = 110-130 mmol/L
    -Serum/ Plasma: 135-145 mmol/L
    -24 hr urine: 40-220 mmol/dL
    -CSF: 136-150 mmol/L

    Cause Serum Na Urine Na 24 hr Na Urine Osm Serum K


    Overhydration LOW LOW LOW LOW NORMAL/LOW
    SIADH LOW HIGH HIGH HIGH NORMAL/LOW
    Diuretic Use LOW LOW HIGH HIGH LOW
    Diabetes/ LOW NORMAL NORMAL NORMAL -
    Hyperosm

    Pseudohyponatremia:
    -for every 100 mg/dL increase in glucose, serum sodium decreases by 1.6 mmol/L

    Laboratory Determination:
    1. Flame Emission Photometry
    2. Ion-Selective Electrode - Glass Electrode for Na
    3. Colorimetric Method: Albanese-Lein Method)
    - Sodium + zinc Uranyl Acetate = Sodium Uranyl Acetate precipitate
    - Sodium Uranyl Acetate precipitate + water = yellow solution

    POTASSIUM
    -MAJOR INTRACELLULAR CATION
    -Concentraion:
    - CELL: Inside (20x greater) > Outside
    - 90% free or exchangeable; 10% bound to RBC, bone and brain tissues
    -KIDNEY - primary that controls extracellular K
    -Proximal tubule: Compelety reabsorbs of filtered K
    -Distal tubule and Collecting ducts: principal regulation of K excretion
    -Secreted in the gastric juice and reabsorbed by the small intestines
    -Functions:
    -Neuromuscular excitabilty
    -Contraction of the heart
    -ICF volume and H+ concentration
    -Influenced by pH: for every 0.1 unit pH decrease, there is 0.4 increase of K
    Pseudohyperkalemia:
    -Due to: Specimen hemolysis, delayed separation of seerum, EDTA contamination,
    fist clenching with torniquet use, prolonged torniquet application, thrombocytosis,
    Leukemia, IV fluid contamination.
    Pseudohypokalemia:
    - Due to: Leukocytosis (>11.0)
    Sample Consideration:
    - Plasma K+ is lower than serum by 0.1-0.7 mmol/L
    Laboratory determinations:
    1. Colorimetric Method - K+ is determined in a specifically prepared mixture of sodium
    tetraphenylboron producing colloidal suspension whose turbidity is proportional to the K+
    concentration in the sample
    a) Lockhead and Purcell
    2. FES (Color: Violet)
    3. ISE
    a) Glass that is permeable selectively to sodiium
    b) Membrane impregnated with Valinomycin (has changed activity just the
    right size to admit K and exclude others)
    4. AAS

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