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NRSG 102: Med Surg 1 > Exam 1: Sodium Imbalances > Flashcards

Exam 1: Sodium Imbalances Flashcards

1
Q

Most abundant electrolyte in ECF?

A

Na

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2
Q

Concentration of Na?

A

135-145

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3
Q

Primary role of Sodium?

A

Controlling water distribution throughout body, because it doesd not easily cross the cell wall membrane.

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4
Q

What is Sodium regulated by?

A

ADH, Thirst, and RAAS

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5
Q

Loss or gain or sodium is usually accompanied by?

A

Loss or gain of water

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6
Q

SIADH may be associated with?

A

Sodium imbalance

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7
Q

When is Arginine Vasopressin (AVP) released?

A

When there is a decrease in the circulating plasma osmolality, blood volume, or blood pressure

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8
Q

What can oversecrection of AVP cause?

A

SIADH

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9
Q

Sodium Deficit name?

A

Hyponatremia

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10
Q

Sodium Excess Name?

A

Hypernatremia

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11
Q

Hyponatremia Contributing Factors?

A

Loss of Sodium through diuretics, renal disease, gain of wwater, and disease states associated with SIADH

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12
Q

Hyponatremia Signs/Symptoms

A

Anorexia, Nausea and Vomiting, Headache, Decreased BP/Pulse, Dry Skin, Weight Gain, Edema

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13
Q

Hyponatremia Labs Indicate

A

Decreased Serum and Urine Sodium

Decreased Urine Specific Gravity and Osmolality

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14
Q

Hypernatremia Contributing Factors

A

Fluid deprivation in patients who don’t respond to thirst.
Diabetes Insipidus
Watery Diarrhea

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15
Q

Hypernatremia Signs/Symptoms

A

Thirst, Elevated Body Temperature, Seizures, Increased BP and Pulse

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16
Q

Hypernatremia Labs Indicate

A

Increased Serum Sodium
Decreased Urine Sodium
Increased Urine Specific Gravity and Osmolality
Decreased Central Venous Pressure

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17
Q

Hyponatremia refers to serum sodium level that is

A

less than 135 mEq / L

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18
Q

Acute Hyponatremia is commonly the result of

A

a fluid overload in a surgical patient

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19
Q

Chronic hyponatremia is more frequently

A

in patients outside a hospital setting, has longer duration

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20
Q

Low Urine Sodium occurs as

A

the kidneys retains sodium to compensate for nonrenal fluid loss (vomiting, diarrhea, sweating)

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21
Q

High Urine Sodium concentration is associated with

A

renal salt washing

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22
Q

What medications increase the risk of hyponatremia?

A

Anticonvulsants, Oxcarbazepine, Levetiracetam, SSRIs, SErtraline, Paroxetine, or Desmopressin Acetate

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23
Q

Neurologic changes of hyponatremia?

A

Altered mental status, status epilepticus and coma

24
Q

Hyponatremia: What happens as extracellular sodium level decreases?

A

The cellular fluid becomes relatively more concentrated and pulls water into the cells.

25
Q

Acute decreases in sodium may be associated with?

A

Brain herniation, and compression of midbrain strcutres

26
Q

What signs can ocur when Serum Sodium levels decreases to less than 115 mEq/L?

A

Signs of increasing intracranial pressure, such as lethargy, confusion, muscle twitching, focal weakness, hemiparesis, seizures, or death

27
Q

Sodium level in hyponatremia?

A

Less than 135 mEq/L

28
Q

Sodium level in SIADH?

A

May be lower than 100 mEq/L

29
Q

When hyponatremia is due primarily to sodium loss, the urinary sodium content is

A

less than 20 mEq/L, suggesting proximal reabsorption of sodium secondary to ECF volume depletion

30
Q

Hyponatremia SpG?

A

1.002 to 1.004

31
Q

Urinary Sodium Content and SpG when Hyponatremia due to SIADH?

A

Greater than 20 mEq.L and urine specific gravity is usually greater than 1.012

32
Q

Most common treatment for hyponatremia is?

A

Careful administration of sodium by mouth, nasogastric tube, or parenteral route

33
Q

Sodium replacement for patients who can eat and drink?

A

Sodium easily replaced because it is consumed abundantly in a normal diet

34
Q

Sodium replacement for those who cnanot consume sodium?

A

Lactated Ringer solution or isotonic saline (0.9% sodium chloride)

35
Q

usual daily sodium requirement in adults?

A

Approximately 100 mEq

36
Q

In patients with normal or excess fluid volume, hyponatremia is usually treated effectively by

A

restricting fluid

37
Q

Hyponatremia: Pharmacologic Therapy treatments?

A

AVP Receptor Antagonists
Vaprisol
Tolvaptan

38
Q

What do AVP Recceptor Antagonists do?

A

Pharmacologic agents that treat hyponatremia by stimulating free water excretion

39
Q

What does Vaprisol do?

A

Limited to hospitalized patients. May be useful therapy for those patients with moderate to severe symptomatic hyponatremia, but not those with seizures or in a coma

40
Q

What does Samsca do?

A

Oral medication for clinically significant hypervolemic and euvolemic hyponatremia

41
Q

Hyponatremia is a frequently overlooked cause of what?

A

Confusion in older patients who are at increased risk because of decreased renal function

42
Q

What should a nurse monitor?

A

I/O, Weight, and be alert for GI Manifestations

43
Q

Hypernatremia is

A

a serum sodium level higher than 145 mEq/L

44
Q

How is Hypernatremia caused?

A

By a gain of sodium in excess of water or by a loss of water in excess of sodium

45
Q

Hypernatremia can occur in patients with

A

normal fluid volume, or those with FVD or FVE

46
Q

Hypernatremia, what happens in water loss?

A

Patient loses more water than sodium, as a result, the sodium concentration icnreases and the increased concentration pulls fluid out of the cell

47
Q

Common cause of hypernatremia?

A

Fluid deprivation in patients who cannot respond to thirst.

48
Q

Less common causes of hypernatremia??

A

Heat Stroke, NEar Drowning in Sea Water, and Malfunction of hemodialysis or peritoneal dialysis systems

49
Q

Clinical manifestations of hypernatremia?

A

Are owing to increased plasma osmolality causedby an increase in plasma sodium concentration. Water moves out of the cell into the ECF

50
Q

Serum Sodium levels in hypernatremia?

A

> 145 mEq/L

51
Q

Serum Osmolality in Hypernatremia?

A

300 mOsm / kg

52
Q

Urine SpG and Urine Osmolality in hypernatremia?

A

Increased as kidneys attempt to converse water.

53
Q

Treatment of hypernatremia consists of

A

gradual lowering of the seurm sodium level by the infusion of a hypotonic electrolyte solution (0,3% sodium chloride) or an isotonic nonsaline solution (dextrose 5% in water).

54
Q

Why is Hypotonic thought to be safer than Isotonic?

A

Allows gradual reduction in the serum sodium level, thereby decreasing the risk of cerebral edema

55
Q

How should a nurse prevent hypernatremia?

A

By providing oral fluids at regular intervals

56
Q

How should a nurse prevent hypernatremia if patient unconscious?

A

By enteral feedings or by the parenteral route.

NRSG 102: Med Surg 1 (52 decks)

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