Disorders of salt and water Flashcards
hypernatremia
water content of body fluid is deficient in relation to sodium content (>145)
either too much salt or not enough water
what does hypernatremia usually result from?
inadequate fluid intake or excess water loss.
causes: deficit of thirst hypotonic fluid loss urinary loss GI loss insensible loss burns diuretic theraphy osmotic diureses (hyperglycemia or mannitol administration) sodium excess DI
what population does Hypernatremia usually presnet?
elderly and infants w/ D
what are clinical features of hypernatremia?
neruological manifestations that result from alterations in the brain water content and include thirst, restlessness, irritability, disorientation, lethargy, delierium, convulsion, coma
-possible brain cell shrinkage that can cause damage to the supporting vasculature
what are some signs of hyper N
dry mouth, dry mucus membranes, lack of tears and decreased slivation, flushed skin, tachycardia, hypotension, fever, oliguria, anuria, hyperventilation, lethargy, hyperreflexia
what can you look at in children to test for dehydration?
clinical dehydration scale
diagnostic studies of hyperN
serum >145
when would urine sodium be decreased?
if hyper N is due to extrarenal losses
when is urine sodium increased?
if hyper Na is due to renal loss or sodium excess
when is urine dilute in hyper Na?
DI
tx of hyper na
inpatient
what is the medication route for hyperNa
free water (po preferred, but can do IV or SQ) as a %5 dextrose solution in water or saline
what should be treated first in hyperNa?
hypovolemia- w/ isotonic saline or lactated ringers
then hyper na
when should dialysis be implemened?
if sodium is greater than 200
what must you be cautious of when treating hyperNa?
pulmonary or cerebral edema!! especially in pts w/ DM
-don’t rapidly correct
