Hyponatremia

Question 1

Definition of Hyponatremia

Answer 1

Serum sodium < 135 mEq/L

Question 2

What percent of VLBW have Hyponatremia?

Answer 2

33%

Question 3

When facing hyponatremia - what questions should you have?

Answer 3

1. Is there seizure activity
2. Intake - how much sodium/free water?
3. Weight - gain or less
4. Output - UOP
5. Medication?
6. Maternal history of
7. Maternal medication
8. what

Question 4

What timeframe is early-onset hyponatremia?

Answer 4

< 1 week

Question 5

What is late-onset hyponatremia?

Answer 5

> 2 weeks or older AFTER achieving full feeds

Question 6

What are some common causes of early-onset hyponatremia?

Answer 6

Maternal - increase maternal free water intake labor, Perinatal non-osmotic release of vasopressin from stresses

Infant - too much free water being given or not enough sodium in fluids

Question 7

What is the most likely causes and less common causes of late-onset hyponatremia?

Answer 7

NEGATIVE SODIUM BALANCE

1. Inadequate/low sodium intake
2. Excessive sodium loss (preterm infants due to immature renal or intestinal function)
3. Diuretic therapy

Less Common causes -
4. Mineralcorticoid deficiency
5. Excessive ADH release
6. Renal Failure in infants
7. Edema causing rentention of free water