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Transcript of Hyponatremia
Blood loss (external injury or internal bleeding)
Decreased blood clotting ability
Diarrhea or vomiting
Excessive sweating (which can result from heat exposure)
Extremes of age (infants and the elderly may be unable to take fluids)
Kidney diseases resulting in increased urination
Placenta previa (placental tissue on top of the cervix) or abruption (early detachment of the placenta)
Use of diuretics
Inadequate fluid intake
Blood transfusion reaction
Chronic liver disease/liver failure
Surgery / operation complications
• Serum sodium osmolality
• Urine osmolality
• Urine sodium, potassium, and chloride concentrations
by Laura Jordan
• Serum sodium concentration of less than 135 mEq/L as a result of an accumulation of total body water greater than the body's accumulation of electrolytes
• Classification according to volume status
i. Hypovolemic hyponatremia
ii. Euvolemic hyponatremia
iii. Hypervolemic hyponatremia
Definition: sodium depletion in excess of water depletion.
Dry mucous membranes
Loss of skin elasticity
Decreased urine output.
Change in mental status
Orthostatic or persistent hypotension
Seizures (due to cell swelling and disturbances in CNS)
Definition: normal body sodium with increase in total body water
Low urine output
Increased urine osmolality
SIADH (most common cause)
CNS disorders (trauma, subarachnoid hemorrhage, tumors, infections, encephalitis, Guillain-Barré syndrome, and acute psychosis)
Excessive oral fluid intake
Postop period (transient increase in ADH)
MDMA or "ecstasy"
Definition: increase in total body sodium with greater increase in total body water
Crackles on auscultation
Edema - particularly hands, feet, and ankles
Difficulty breathing while lying down
High blood pressure
Jugular vein distension
Shortness of breath
Strong, rapid pulse
Controlling loss of fluid or blood
Replacing those fluids and blood
Blood plasma transfusion
Cryoprecipitate transfusion (provides fibrinogen, required for clotting)
Intravenous colloids (solutions containing complex sugars known as dextrans, proteins, or starches)
Intravenous crystalloids (salt solutions)
Red blood cell transfusion
Vasopressors (medications such as norepinephrine, epinephrine, dopamine, and vasopressin that increase the blood pressure)
Treatment of underlying condition; Ex.
moderate SIADH give hypertonic saline
Treatment of underlying cause
Angiotensin receptor blockers