Hyponatremia

Question 1

What is the normal range of sodium

Answer 1

135-145 mEq/L

Question 2

What is considered hyponatremia

Answer 2

<135 mEq/L

Question 3

What is hyponatremia on a cellular level

Answer 3

Large amounts of sodium has moved into the cell, followed by the water
Caused by osmosis
Increased water in the cell can cause cell to burst

Question 4

What does sodium do in the body

Answer 4

Helps regulate water intracellular and extracellular

Water wants to be where the sodium is

Question 5

What is euvolemic hyponatremia

Answer 5

Water in body increases but sodium stays the same
Edema will not be present
Sodium becomes diluted due to large amounts of water

Question 6

What causes euvolemic hyponatremia

Answer 6

SIADH (ADH is increased, so body retains water)
Diabetes insipidus
Adrenal insufficiency
Addison’s disease

Question 7

What is hypovolemic hyponatremia

Answer 7

Body is dehydrated

Decrease in sodium and decrease in water

Question 8

What causes hypovolemic hyponatremia

Answer 8

Vomiting
Diarrhea
NG suction
Diuretic therapy
Burns
Excessive sweating

Question 9

What is hypervolemic hyponatremia

Answer 9

Water and sodium increase in the body
Fluid volume overload
Sodium becomes diluted (water and sodium are regulated differently)

Question 10

What causes hypervolemic hyponatremia

Answer 10

Congestive heart failure
Kidney failure
Excessive infusion of saline
Liver failure

Question 11

Pneumonic for causes

Answer 11

“No Na+”
Na+ excretion increased w/ renal problems, NG suction, vomiting, diuretics, sweating, diabetes insipidus, aldosterone secretion
Overload of fluids (CHF, hypotonic fluids, liver failure)
Na+ intake low through low salt diet or NPO status
Antidiuretic hormone oversecreted (SIADH)

Question 12

S&S of hyponatremia

Answer 12

“SALT LOSS”
Seizures + stupor
Abdominal cramping + attitude changes (confusion)
Lethargic
Tendon reflexes diminishes, trouble concentrating

Loss of urine + appetite
Orthostatic hypotension, overactive bowel sounds
Shallow respirations (happens late due to skeletal muscle weakness)
Spasms of muscle

Question 13

General interventions for hyponatremia

Answer 13

• watch cardiac, respiratory, neuro, renal, & GI status
• if pt is taking lithium, check drug levels. Body won’t excrete lithium as well when sodium isn’t correct
• instruct pt to consume sodium rich foods

Question 14

Interventions for hypovolemic hyponatremia

Answer 14

• administer IV sodium solution to restore fluids + sodium
• 3% saline hypertonic solution
• usually given through central line
• hard on veins, close monitoring -> fluid volume overload if done too fast

Question 15

Interventions for hypervolemic hyponatremia

Answer 15

• restrict fluids
• diuretics sometimes ordered to excrete extra water and conserve sodium
• if pt has renal failure, may receive dialysis

Question 16

Interventions for SIADH induced hyponatremia

Answer 16

• restrict fluids
• treat with antidiuretic hormone antagonist
• declomycin (don’t give with food, esp dairy and antacids)

Question 17

Foods rich in salt

Answer 17

Bacon
Butter
Canned foods
Cheese
Hot dogs
Lunch meats
Processed foods
Table salt