ELECTROLYTES: SODIUM

Question 1

Sodium

Normal Sodium Serum Level

Answer 1

135-145 mEq/L

Question 2

Sodium

Hyponatremia

1. Level
2. s/s
3. Tx

Answer 2

1. Level <135
2. s/s:

• With decrease ECV: Bounding pulse, Increase Pulse, decrease BP
• With increase ECV: (all above) but Increase BP
• CONFUSION, LETHARY, N/V

3. TX:

• Increase foods with salt
• If low sodium but normal vol levels use water restrict and tx underlying cause
• If low sodium with hypovolemia use IV NS or LR
• If low sodium with hypertonic dehydration, tx with fluid restriction and tx underlying causes
• Use Isotonic saline for irrigations instead of water to prevent further fluid shifting and Na+ deficit
• Monitor I&O, daily weights
• SAFETY PRECAUTION IF CLIENT IS CONFUSED

*

Question 3

Sodium

Hypernatremia

1. Level
2. s/s
3. Tx

Answer 3

Level: >145

s/s:

• Increase pulse and BP
• Decrease cardiac contractility
• ROUGH DRY TONGUE
• CNS IRRIABILITY SEIZURES COMA, TWITCHING TREMORS

Tx

• Restrict dietary Na+ can also be in OTC meds
• Increase Na with euvolemia, used water tx underlying cause
• Increase Na with hypovolemia, tx with NS initially
• Increase Na with hypervolemia, tx with diuretic
• I&O, daily weights