- Sodium is the most abundant cation in the blood and its chief base. It functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. Very Low value: seizure and Neurologic Sx.
Normal Adult Range: 135-146 mEq/L
Optimal Adult Reading: 140.5
• POTASSIUM
- Potassium is the major intracellular cation. Very low value: Cardiac arythemia.
Normal Range: 3.5 - 5.5 mEq/L
Optimal Adult Reading: 4.5
• CHLORIDE
- Elevated levels are related to acidosis as well as too much water crossing the cell membrane
Decreased levels with decreased serum albumin may indicate water deficiency crossing the cell membrane (edema). - Diabetes
Normal Adult Range: 95-112 mEq/L
Optimal Adult Reading: 103 mEq/L
Discussion
Chloride contributes to the body’s acid/base balance. Along with Sodium, Potassium and Carbon Dioxide, it is important in evaluating acid/base relationships, state of hydration, adrenal and renal functions. Its level varies inversely with Carbon Dioxide. Chloride elevation indicates acidosis, decrease indicate alkalosis.
• CO2 (Carbon Dioxide)
- The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system. Generally when used with the other electrolytes, it is a good indicator of acidosis and alkalinity.
Normal Adult Range: 22-32 mEq/L
Optimal Adult Reading: 27
Normal Children's Range - 20 - 28 mEq/L
Optimal Children's Reading: 24
• CALCIUM
involved in bone metabolism, protein absorption, fat transfer muscular contraction, transmission of nerve impulses, blood clotting and cardiac function. Regulated by parathyroid.
Normal Adult Range: 8.5-10.3 mEq/dl
Optimal Adult Reading: 9.4
Discussion
Serum calcium is not at all reflective of total body stores of calcium but rather reflects the metabolic and hormonal state of the individual. Ionic or free calcium is not only the biologically active form of calcium but reflects the amount of albumin and the blood pH.
Serum calcium can not be properly interpreted without serum albumin level. Use the formula Adjusted Calcium = Serum calcium - serum albumin + 4. By far the most common causes of hypocalcaemia are primary hyperparathyroidism, malignancy, and drug-induced. A PTH, calcium, albumin and phosphorus level drawn simultaneously helps classify the etiology into main groups. Watch for signs of calcium deposition and kidney stones.
• MAGNESIUM
Optimal Range: 2-3 mg/DL
Discussion
The serum magnesium is not reflective of total magnesium stores. Unfortunately there is not a good test for magnesium, but a red cell Mg level is preferable to serum magnesium. Approximately 2/3 to ¾ of magnesium in blood is not attached to protein.
• PHOSPHORUS
- Generally inverse with Calcium.
Normal Adult Range: 2.5 - 4.5 mEq/dl
Optimal Adult Reading: 3.5
Normal Children's Range: 3 - 6 mEq/dl
Optimal Children's Range: 4.5
• ANION GAP (Sodium + Potassium - CO2 + Chloride)
- An increased measurement is associated with metabolic acidosis due to the overproduction of acids (a state of alkalinity is in effect). Decreased levels may indicate metabolic alkalosis due to the overproduction of alkaloids (a state of acidosis is in effect).
Normal Adult Range: 4 - 14 (calculated)
Optimal Adult Reading: 9
• CALCIUM / PHOSPHORUS Ratio
Normal Adult Range: 2.3 - 3.3 (calculated)
Optimal Adult Reading: 2.8
Normal Children’s range: 1.3 - 3.3 (calculated)
Optimal Children’s Reading: 2.3
• SODIUM / POTASSIUM
Normal Adult Range: 26 - 38 (calculated)
Optimal Adult Reading: 32
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