How to interpret laboratory data:electrolytes

decrease	Increase	Normal range
		SI	conventional
Hyponatremia 1-(dilutional hyponatremia) excess accumulation of body water due to: CHF, cirrhosis, severe burns, chronic renal failure, nephrotic syndrome. 2-Sodium depletion Due to: SIADH, cystic fibrosis, mineralocorticoid deficiency, Na free fluid replacement SIADH= (syndrome of inappropriate antidiuretic hormone) SIADH may be associated with disease states such as cancer or  the use of medications including chlorpropamide, thiazide diuretics, and carbamazepine.	Hypernatremia 1-Increased sodium intake. 2-Increased fluid loss. hypernatremia usually occurs in individuals who are unable to obtain adequate fluid intake. Fluid loss from - gastroenteritis - diabetes insipidus, - Cushing disease, - hyperaldosteronism - administration of hypertonic saline solution	135-147 mmol/L	135-147 mEq/L	Sodium (Na+) is the most prevalent cation in the extracellular fluid. Sodium is important in: regulating serum osmolality, fluid balance,   acid-base balance. In addition, sodium also assists in maintaining the electric potential necessary for transmission of nerve impulses.
hypokalemia severe diarrhea and/or vomiting, respiratory alkalosis, hyperaldosteronism, Cushing disease, alcoholism Medications: amphotericin B thiazide, loop, osmotic diuretics. If a patient is hypokalemic and potassium supplements have not helped to correct the low potassium, check to see if the magnesium is also low. Decreased potassium is difficult to correct while magnesium remains low.	Hyperkalemia metabolic or respiratory acidosis, renal failure, Addison disease, dehydration, massive cell damage from burns, injuries, and surgery. Medications: (ACE) inhibitors, (ARBs), potassium supplements K-sparing diuretics drospirenone	3.5-5.2 mmol/L	3.5-5.2 meq/L high potassium value may be reported if the specimen was hemolyzed when the laboratory test was performed	Potassium (K+) is the main intracellular cation. Serum concentrations of potassium are not always an accurate indicator of potassium levels because potassium is an intracellular ion. Potassium plays a key role in many bodily functions, including: regulation of nerve excitability, acid-base balance, muscle function. Cardiac function and neuromuscular function can be significantly affected by either an increase or decrease in potassium levels.
Hypochloremia prolonged vomiting, gastric suctioning, metabolic alkalosis, CHF, SIADH, Addison disease, medications H2 blockers proton pump inhibitors [PPIs]	Hyperchloremia metabolic acidosis, respiratory alkalosis, dehydration, diabetes insipidus, eclampsia, renal disorders.	95-106 mmol/L	95-106 mEq/L	Chloride Cl is the principal extracellular anion. Chloride primarily serves a passive role in the maintenance of fluid balance and acid-base balance. Serum chloride values are useful in identifying fluid or acid-base balance disorders.
metabolic acidosis. diabetic ketoacidosis, methanol toxicity, salicylate toxicity, lactic acidosis, renal failure.	metabolic alkalosis. diuretic therapy, primary aldosteronism, Bartter syndrome.	22-30  mmol/L	22-30 mEq/L	Carbon Dioxide Content The majority of CO2 in the plasma is present as bicarbonate ions, and a small percentage is dissolved CO2. The CO2 content is the sum of both bicarbonate ions and dissolved CO2. CO2 and bicarbonate are extremely important in regulating physiologic pH. CO2 content is composed mostly of bicarbonate (HCO3−) and is a base. CO2 content is regulated by the kidneys.
	Clinical Significance Anion gap may be elevated in conditions such as renal failure, lactic acidosis, ketoacidosis, salicylate toxicity, methanol toxicity , ethylene glycol toxicity.	3-11 mmol/L	3-11 mEq/L	Anion Gap The anion gap is calculated using the following formula: Anion gap = [Na+ - (Cl2 + HCO3 2)] Anion gap is reflective of unmeasured acids. An increase in anion gap suggests an increase in the number of negatively charged weak acids in theplasma. Anion gap is useful in evaluating causes of metabolic acidosis.