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Sodium plays a central role in maintaining the normal distribution of water and the osmotic pressure in the extracellular fluid compartment. Hyponatremia (low sodium) is a predictable consequence of decreased intake of sodium. Occurs in nephrotic syndrome, hypoproteinemia, primary and secondary adrenocortical insufficiency, and congestive heart failure. Hypernatremia (high sodium) is often attributable to excessive loss of sodium-poor body fluids. associated with hypercalcemia and hypokalemia and is seen in liver disease, cardiac failure, pregnancy, burns, and osmotic diuresis. Ref. value: > or =1 year: 135-145 mmol/L. Potassium is the major cation of the intracellular fluid. Disturbance of potassium homeostasis has serious consequences. Decreases in extracellular potassium are characterized by muscle weakness, irritability, and eventual paralysis. Hypokalemia (low potassium) is common in vomiting, diarrhea, alcoholism, and folic acid deficiency. Abnormally high extracellular potassium levels produce symptoms of mental confusion; weakness, numbness, and tingling of the extremities; weakness of the respiratory muscles; flaccid paralysis of the extremities; slowed heart rate; and eventually peripheral vascular collapse and cardiac arrest. Potassium should be monitored during treatment of many conditions but especially in diabetic ketoacidosis and any intravenous therapy for fluid replacement.
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