Hyponatremia

Question 1

Hypovolemic

Answer 1

Diuretic excess, hypoaldosteronism,
vomiting, NG suction, burns, pancreatitis,
diaphoresis

Question 2

Euvolemic

Answer 2

SIADH, CNS abnormalities, drugs

Question 3

Hypervolemic

Answer 3

Renal failure, CHF, liver failure
(cirrhosis), iatrogenic fluid overload
(dilutional)

Question 4

What are the signs/

symptoms?

Answer 4

Seizures, coma, nausea, vomiting, ileus,

lethargy, confusion, weakness

Question 5

What is the treatment of the
following types:
Hypovolemic
Euvolemic
Hypervolemic

Answer 5

NS IV, correct underlying cause

SIADH: furosemide and NS acutely, fluid
restriction

Dilutional: fluid restriction and diuretics

Question 6

How fast should you
increase the sodium level in
hyponatremia?

Answer 6

Guideline is <12 mEq/L per day

Question 7

What may occur if you correct

hyponatremia too quickly?

Answer 7

Central pontine myelinolysis!

Question 8

What are the signs of central

pontine myelinolysis?

Answer 8

1. Confusion
2. Spastic quadriplegia
3. Horizontal gaze paralysis

Question 9

What is the most common
cause of mild postoperative
hyponatremia?

Answer 9

Fluid overload

Question 10

How can the sodium level in

SIADH be remembered?

Answer 10

SIADH = Sodium Is Always Down
Here = Hyponatremia

Question 11

What is Pseudohyponatremia?

Answer 11

Spurious lab value of hyponatremia as a
result of hyperglycemia, hyperlipidemia,
or hyperproteinemia