Lecture 4 management of electrolytes Flashcards
Whats Hyponatremia
soduim loss < 135 mmol/L
Severe=< 125 Meq/L
Causes hyponatremia
- Loss Na-containing fluid
- Water excess
What does Hyponatremia lower…
Plasma osmolality, shifting fluid into brain cells
Symptoms hyponatremia:
-Neuro related
-Changes LOC
ECF fluid volume symptoms for patient with hyponatremia
- abnormal decrease in soduim loss (Hypovolemic hypontremia)
2.Abnormal increase in watter gain (hypervomeic hyponatremia)
Treatement of hypoatremia
Iv’s, get soduim back
What are severe symptoms of hypertonic saline/ what would you administer…
Seizures
administer (3% Nacl)
A hypertonic saline solution causes water to shift ______cells
outside cell causing cell death
Why must Iv hypertonic saline be administered with caution
Much higher concentrated salt, cell’s could collapse
What’s the max rate of safe administration for hypertonic saline (3% Nacl)
100 ml/hr
How is Hypertonic saline given
IV infusion pump
What’s Hyperatremia
increase in soduim retention >145 mmol/L
life threatening at level >155 mmol/L
high mortality >180 mmol/L
Hypernatremia prevalence seen more in….
Critically ill patients particularly with neuro condition
1/5 of people with congestive heart failure experience….
Hypernatremia
what are people with high protein tube feeding at risk for
Hypernatremia
Causes Hypernatremia
water deficiency, and NA accumulation, usually just looks like a water definiency. FEVER, HEATSTROKE
Does hypernatremia cause hyperosmolarity
YES! hyperosmolarity is a shift of water out of cells- cellular dehydration
usually body does things to prevent hypernatremia
-stimulate thirst
-ADH release
What’s hypothalamic disorder:
Lesion may cause disturbance of thirst mechanism but is rare
Clinical manifestations of Hypernatremia:
-Change plasma osmolality
-Neurologic changes
-Nausea vomiting
-restlessness
-Thirst
-Body can tolerate high sodium levels
Interventions for Hypernatremia:
-Remove sodium intake from diet
but if soduim go even lower give D5W IV
Interventions for hyponatremia:
-Fluid restriction
But treatment associated with abnormal fluid loss give sodium containing solutions.
Patient has sodium level 188 Meq/L and not drinking water: what is diagnosis..
Hypo(check)volemic Hypernatremia
What is hypokalemia
Low levels of potassium in the ECF