Sodium

Question 1

sodium range

Answer 1

135-145

Question 2

obtained?

Answer 2

diet

Question 3

excreted?

Answer 3

kidneys

Question 4

absorbed?

Answer 4

small intestine

Question 5

functions of sodium

Answer 5

blood pressure, blood volume, ph balance

Question 6

regulated by?

Answer 6

ADH, aldosterone, Na-K pump

Question 7

hyponatremia is less than

Answer 7

135

Question 8

hyponatremia causes

Answer 8

Na excreting w renal problems, NG suction, vomiting, diuretics, sweating, diarrhea, decreased secretion of aldosterone (DI)

Overload of fluid (CHF, RF, hypotonic fluids infusion)

Na intake low (low Na diet, NPO)

Antidiuretic hormone over secretion (SIADH)

Question 9

hyponatremia signs and symptoms

Answer 9

Seizures and stupor
Abd. cramping
Lethargic
Tendon reflex diminished
Loss of urine & appetite
Orthostatic hypotension
Shallow respirations
Spasms of muscles

Question 10

labs for hyponatremia

Answer 10

Na <135
serum osmolality <280

Question 11

treatment for hyponatremia

Answer 11

-Na replacement (PO, IV, NGT)
-replacement depends on the rate lost (can use LR NS / when replacing, watch for signs of fluid overload or pulmonary edema - replace slow)
-serum Na must not be increased >12 in 24 hrs

Question 12

treatment for hyponatremia
water gain

Answer 12

-better to restrict H2O than to give Na (800ml/24hr)
-hypertonic solution 3-5% NaCl
-edema only - restrict Na
-edema and low Na - restrict both
-loop diuretics

Question 13

nursing interventions for hyponatremia

Answer 13

-identify pt at risk
-review meds (lithium with low Na)
-GI manifestations
-monitor for s/s of hyponatremia
-monitor for neuro changes
-oral hygiene

Question 14

hypernatremia range

Answer 14

> 145

Question 15

hypernatremia causes

Answer 15

Hydrocorticolism

Increased Na intake

GI feeding w not enough H2O

Hypertonic solutions

Sodium excretion decreased and corticosteroids

Aldosteronism (hyper)

Loss of fluids

Thirst impairment

Question 16

hypernatremia signs and symptoms

Answer 16

Fever, flushed skin

Restless, agitated

Increased fluid retention

Edema, confused

Decreased urine output, dry mouth/skin

Question 17

hypernatremia lab

Answer 17

Na >145
serum osmolality >300

Question 18

hypernatremia medical treatment

Answer 18

-decrease Na level gradually
-monitor for neuro changes and cerebral edema
-hypotonic solution D5W or 0.45%NS
-desmopressin