Sodium Flashcards
Treatment:
- Asymptomatic/mild SIADH =
- Symptomatic SIADH =
- fluid restriction
- hypertonic saline (3%)
What is the likely diagnosis in a euvolemic patient with low serum osmolality (< 275 mOsm/kg) and high urine osmolality (> 100 mOsm/kg)
and increased urinary sodium levels (> 40 mEq/L)?
SIADH
What is the treatment of choice for severe hypovolemic hypernatremia?
0.9% saline (isotonic) until euvolemic, then D5W (hypotonic)
What is the treatment of choice for mild hypovolemic hypernatremia?
D5½NS (5% dextrose in 0.45% saline)
What is the next best step in evaluating hypovolemic hypotonic hyponatremia?
Measure urine Na+
Cerebral edema can develop as a complication of overly rapid correction of _____
hypernatremia
Osmotic myelinolysis (or osmotic demyelination syndrome; ODS) is a severe complication of rapid correction of ____
hyponatremia
Which electrolyte disturbance causes nausea, malaise, stupor, coma, and seizures?
Low Na+ (hyponatremia)
What is the initial treatment for acute hyponatremic encephalopathy (e.g., headache, nausea / vomiting, AMS)?
Hypertonic saline (3%)
Correction of serum sodium (both hypo- and hyper-natremia) should not exceed a rate of_____
0.5 mEq/L/hr
Hypovolemic hyponatremia is managed with:
Isotonic normal saline
What is the most likely diagnosis for an elderly patient with nausea, lethargy, polyuria, dry mucous membranes, and cough?
Hyperosmolar hyperglycemic state
What is the treatment for hyperosmolar hyperglycemic state (HHS)?
Intense IV fluids and insulin therapy
What is the effect of hyperglycemia (e.g., DKA/HHS) on serum sodium levels?
Hyponatremia (low Na+)
Cushing syndrome is more likely to present with ____kalemia and ____natremia
hypo
hyper
