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Module 1 : Physiology



In Disease


In some disease states electrolyte losses may be very high. These patients will need careful monitoring and replacement of electrolytes.


For example: gastrointestinal losses are often high in potassium, and these patients may require potassium supplementation to levels that would be dangerous to a ‘healthy’ person.


The loss of anions in GI disease includes bicarbonate losses in small bowl content. If the losses are high, the bicarbonate should be replaced directly or with a bicarbonate precursor such as lactate. Replacement with sodium chloride (normal saline fluid) in this instance may worsen the acidotic state.  


However, in other disease states electrolyte losses may be low, or patients may be particularly sensitive to high concentrations of electrolytes, for example patients with chronic kidney disease or cardiac arrhythmia respectively. These patients may require restriction of certain electrolytes.


It is vital to always consider the needs of the individual patient when prescribing fluids or electrolytes, as will be discussed in module 3 : prescribing.



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