CLINICAL APPLICATIONS/DETERMINATION/METHODS OF SODIUM Flashcards
CAUSES OF HYPONATREMIA
Increased Sodium Loss
Increased Water Retention
Water Imbalance
Causes of Increased Sodium Loss
Hypoadrenalism (↓aldosterone)
Potassium deficiency
Diuretic use (thiazide)
Ketonuria (Na loss w/ketones)
Salt-losing nephropathy
Prolonged vomiting or diarrhea
Causes of Increased Water Retention
Renal failure (dilution of Na)
Nephrotic syn. (↓COP-PV, ↑AVP)
CHF, Hepatic cirrhosis
Causes of Water Imbalance
SIADH (↑AVP, ↑water retention)
Pseudohyponatremia
SIADH means
Syndrome of Inappropriate Anti-Diuretic Hormone
During Potassium deficiency:
aldosterone will promote Na+ reabsorption, which in return, promote K+ excretion in urine
K+ is increased in plasma
During Potassium deficiency:
K+ must be conserved by the kidneys, in return, Na+ will be excreted in urine
K+ is decreased in plasma
What are the CLASSIFICATION OF HYPONATREMIA BY OSMOLALITY?
WITH LOW OSMOLALITY
WITH NORMAL OSMOLALITY
WITH HIGH OSMOLALITY
↑ Sodium loss
Increased water retention – all solutes including sodium are diluted
WITH LOW OSMOLALITY
Sodium is decreased but the plasma osmolality is not affected.
WITH NORMAL OSMOLALITY
Causes of NORMAL OSMOLALITY
Increased non-sodium cations
Lithium excess (drug medication)
Increased gamma globulins
Severe hyperkalemia
Severe hypermagnesemia
Increased non-sodium cations
Lithium excess (drug medication)
Increased gamma globulins
Severe hyperkalemia
Severe hypermagnesemia
Other solute concentration is too high
Examples: Hyperglycemia, Mannitol Infusion
WITH HIGH OSMOLALITY
CAUSES OF HYPERNATREMIA
Excess Water Loss
Decreased Water Intake
Increased Intake or Retention of Sodium
Causes of Excess Water Loss
Diabetes insipidus (↓AVP)
Renal tubular dis. (↓urine conc.)
Prolonged diarrhea
Profuse sweating
Severe burns
Causes of Decreased Water Intake
Old/infants/mental impairment
Causes of Increased Intake or Retention of Sodium
Cushing syn. (↑Na reabsorption)
Hyperaldosteronism (↓AVP)
Hypertonic salt solution
What are the tube and specimen needed for Specimen Collection of Sodium?
Serum (red); Plasma (green: Lithium heparin, Ammonium heparin, Lithium oxalate)
T/F. False ↑ with MARKED HEMOLYSIS because sodium is also seen inside the cell
True
What are the interfering agents that might encounter in Sodium?
Hgb, Lipids, and Bilirubin
T/F. In Flame Emission Spectroscopy, the color of sodium after excitation is RED
False, YELLOW
NOT COMMONLY USED for sodium
It is used for ions that are not easily excited.
Atomic Absorption Spectroscopy
The REFERENCE METHOD as it is rapid (STAT)
Ion Selective Electrode
T/F. In Ion Selective Electrode, uses Glass ion-exchange membrane for sodium
True
COLORIMETRIC METHOD for sodium determination
Albanese-Lein
