Electrolyte management

A balance must be achieved between electrolyte intake and output. Consider:

• Altered intake

• Impaired renal excretion

• Increased body losses

• Body compartment redistribution (e.g. increased capillary leak, secondary hyperaldosteronism) As well as Na + and K+, consider Mg2 + , Ca2 + , Cl- and PO43- balance.

Plasma electrolyte values are poorly reflective of whole body stores; however, excessively high or low plasma levels may induce symptoms and deleterious physiological and metabolic sequelae.

Water balance must also be taken into account; depletion or excess repletion may respectively concentrate or dilute electrolyte levels.

The usual daily requirements of Na+ and K+ are 60-80 mmol.

Gravitational peripheral oedema implies increased total body Na+ and water, though intravascular salt and water depletion may coexist.

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