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Transcript of Sodium- Na
Hyponatremia: Na< 135 mEq/L.
Hyonatremia with hypervolemia? If less Na than normal in the bloodstream, water will osmose into cells, and cells will swell. This is dangerous for brain cells, leads to neurological symptoms, especially when Na < 115 mEq/L.: headache, confusion, lethargy, twitching, seizures, coma and death if not corrected.
SIADH- syndrome of inappropriate anti-diuretic hormone secretion: d/t brain injury, surgery or tumor, too much ADH secreted by pituitary gland. Can also be caused by ADH secretion by tumors.
Treatment of Hypervolemic Hyponatremia and SIADH
Fluid restrictions-1200mls/day Furosemide
NaCl tablets or increase salt in diet
Tolvaptan- ADH receptor antagonist
Hypertonic 3%-5% Saline IV for severe hyponatremia, give slowly on pump: danger of fluid overload and danger of osmotic demyelinization- permanent brain damage. Bring Na up gradually: no faster than 1 mEq/hr and no more than 12 mEq/day.
Hyponatremia- Na < 135 mEq/L.
Must look at water balance in the body.
Hyponatremic and dehydrated d/t G-I loss or diuretics? Symptoms of orthostatic hypotension. Treat with 0.9% Normal Saline IV over a few days until Na and fluid balance restored. Observe intake and output.
Hypernatremia: Na > 145mEq/L.
Due to fluid loss or excessive Na intake.
Fluid loss: G-I loss, fever, hyperventilation, inadequate fluid intake, diabetes insipidous.
Excessive sodium intake: medications i.e. corticosteroids, sodium bicarbonate, Kayexalate.
Symptoms- Neurological: Early- restlessness, agitation, anorexia, flushed skin, N & V. Later- weakness, lethargy, confusion, twitching, tremors, stupor, seizures, death.
Treatment: gradual lowering of Na levels with hypotonic IV fluids.
Nursing responsibilities with hyponatremic client.
Monitor sodium levels
Assess neurological symptoms
Keep accurate intake and output
Monitor daily weights
Administer ordered IV fluids
Explain and enforce fluid restrictions if ordered
Normal serum Na level: 135-145 mEq/L.
Major extracellular electrolyte.
Transmits impulses in nerves and muscles.
Major determinant of serum osmolality.
Water follows sodium.