Sodium Flashcards
1
Q
Sodium?
A
- Most abundant cation in ECF
- Only small amt found in ICF
- Normal serum value 135-145 mEq/L
- Absorbed via GI & eliminated through urine
- Most important electrolyte regulating osmolality
- Important role in generation & transmission of impulses in nerves & muscles
- Helps regulate acid-base balance
2
Q
Sodium
-Regulation
A
- Thirst
- ADH
- Aldosterone
- ANP
3
Q
Hyponatremia?
A
- Most common electrolyte imbalance seen in hospitalized patients
- Typically associated w/ ECF imbalances
- Inadequate sodium intake
- Increased excretion
- Dilutional (water excess, usually assoc w/ hypervolemia)
4
Q
Hyponatremia
-Risk factors
A
- Sodium loss
- Gain of water
- SIADH
5
Q
Hyponatremia
-Clinical manifestations
A
- Largely result of intracellular shift of water
- Dependent on rapidity & severity of hyponatremia
- Most common sx r/t H20 shift from vascular space into cells and Na+ role in nerve impulse transmission & muscle ctx
- Neurologic symptoms do not develop until Na+ value approx 120-125
- Seizures occur when levels reach 115
6
Q
Hyponatremia
-Lab values
A
- Na+ less than 135 mEq/L
- Serum osmolality less than 280 mOsm/kg
- SG decreased (except w/ SIADH)
7
Q
Hyponatremia
-Interventions
A
- Assess & document LOC, orientation, neuro status w/ V/S
- I&O
- Daily wts
- Monitor serum levels closely
- Free fluid restriction
- Encourage foods high in Na+
- Medications (i.e. Demeclocycline, salt tabs )
- Admin hypertonic 3% saline solution, only if dangerously low (at Least 118 or lower value)
- Don’t correct too quickly to prevent neurologic damage secondary to lysis of myelin
8
Q
Hypernatremia?
A
- Greater than normal concentration of Na+ in ECF
- Caused by excess water loss or overall sodium excess
- May occur w/ water loss, water deprivation, or Na+ gain
- Primary protection against development of hyperosmolality & hypernatremia is thirst
9
Q
Hypernatremia
-Risk factors
A
- Increased sensible & insensible H20 loss
- Diarrhea
- Water deprivation/sodium gain
- Diabetes insipidus
- Excess aldosterone secretion
10
Q
Hypernatremia
-Clinical manifestations
A
- R/t water shift from cells (cellular dehydration) into vascular space
- Also r/t NA+ role in nerve impulse transmission & muscle contraction
11
Q
Hypernatremia
-Diagnostic tests
A
- Sodium greater than 145
- Serum osmolality above 297
- SG increased, except w/ diabetes insipidus
12
Q
Hypernatremia
-Interventions
A
- I&O
- Daily wts
- Assess & document loc, neuro status and orientation w/ v/s
- IV or oral H20 replacement
- Tx diabetes insipidus (Desmopressin acetate)
- Reorient pt, as needed
- Decrease dietary NA+ intake
- Correct hypernatremia slowly, over 2 days
