Sodium Flashcards
What is the primary electrolyte in ECF?
Sodium
What is the sodium concentration in the ICF?
14 mEq/L
What is the role of sodium in muscle and nerve function?
It helps maintain skeletal muscle contraction, cardiac contraction, and nerve impulse transmission.
What hormones assist in regulating sodium levels?
Aldosterone, ADH, and natriuretic peptide
What are the sodium levels for hyponatremia?
A sodium level less than 136
What causes cellular edema in hyponatremia?
Water moves from ECF into ICF
Name 3 risk factors for actual sodium deficit.
Excessive sweating, diuretics, nasogastric suction
Name 3 risk factors for relative sodium deficit due to dilution
SIADH, hypotonic fluid excess, freshwater submersion
What is a common vital sign finding in hypovolemia hyponatremia?
Tachycardia and hypotension
What are common neuromuscular signs of hyponatremia?
Confusion, lethargy, muscle weakness, seizures
What are the GI findings in hyponatremia?
Abdominal cramping, nausea, hyperactive bowel sounds
What lab findings indicate hyponatremia?
Sodium less than 136
Low serum osmolality
Low urine sodium ( high in SIADH)
What is the maximum sodium correction recommended in 24 hrs?
No more than 12 mEq/L
What hypertonic IV solution is used to treat severe hyponatremia?
3% sodium chloride
What is hypernatremia?
Sodium greater than 145 mEq/L
What is the cellular effect of hyponatremia?
Water shifts out of cells causing cellular deshydration
Name 3 causes of actual sodium excess
Kidney failure, Cushing syndrome, excessive sodium intake
Name 3 causes of relative sodium excess due to fluid loss
Diabetes Insipidus, heatstroke, watery stools
What neuromuscular findings occur in hypernatremia?
Restlessness, muscle twitching, seizures.
What GI findings occur in hypernatremia?
Thirst, dry mucous membranes, nausea, vomiting
What lab values are elevated in hypernatremia?
Sodium ↑145 mEq/L
Serum osmolality ↑300 mOsm/L
Increased urine specific gravity
What IV fluid helps gradually reduce sodium in hypernatremia?
0.3% sodium chloride
What solution becomes hypotonic after infusion due to glucose metabolism?
Dextrose 5% in 0.45% sodium chloride
What dietary advice is important for hypernatremic patient?
Encourage water intake and restrict sodium intake
What medication is used to promote sodium excretion. In hypernatremia
Loop diuretics
What is a severe complication of untreated hypernatremia?
Seizures, coma, or death
What is a key nursing action when administering 3% NaCl?
Infuse slowly and monitor sodium levels frequently
What precautions should be taken for both hypo- and hypernatremia?
Implement seizure precautions
What dietary recommendations is important for hyponatremic patients?
Consume a high-sodium diet
What IV solutions is preferred for hypernatremia with severe hyperglycemia?
0.3% sodium chloride
What is an example of hypotonic solution
Dextrose 5% in water
What should patients with hypernatremia avoid?
Sodium bicarbonate-containing OTC medications
What interprofessional consult may help with sodium-restricted diets?
Nutritional services a
How does aldosterone affect sodium?
It promotes sodium retention in the kidneys
How does ADH influence sodium and water balance?
ADH retains water but does not directly retain sodium
What is natriuretic peptides role in sodium balance
It promotes sodium and water excretion to lower blood pressure and volume
What sodium imbalance can SIADH cause?
Hyponatremia due to water retention
What is cerebral salt wasting syndrome?
A condition where excessive sodium is excreted by the kidneys, causing hyponatremia
What happens to ECF osmolality in hyponatremia
It decreases
What IV solutions is isotonic and often used to correct hyponatremia?
0.9% sodium chloride
What is the main complication of rapid correction?
Osmotic demyelination syndrome
What role does hyperglycemia play in sodium balance?
It can cause a dilutional hyponatremia due to osmotic diuretics.
How can psychogenic polydipsia affect sodium levels?
It can cause dilutional hyponatremia due to excessive water intake.
What type of solution is 3% NaCl?
Hypertonic
What condition is characterized by ADH deficiency leading to hypernatremia?
Diabetes Insipidus
What is the most reliable indicator of fluid status?
Daily weight
What electrolyte imbalance may be caused by excessive sweating?
Hyponatremia
What is the ECF sodium concentration in hypernatremia?
Greater than 145 mEq/L
What symptom is a hallmark of hypernatremia
Intense thirst
What IV fluid should be avoided in hypernatremia?
Hypertonic saline solutions Ike 3% NaCl
What lab finding is common in SIADH-related hyponatremia?
Increased urine sodium(>20 mEq/L)
What is the effect of ADH open urine concentration?
ADH increases urine concentration
What is the normal range of serum sodium
136-145 mEq/L
What is an expected serum osmolality in hypernatremia?
Greater than 300 mOsm/kg
