Sodium Flashcards
where is sodium mostly located?
extracellular
what is one of the most important thing sodium does?
attracts fluid
what are some other thing sodium does?
transmit impulses in nerve and muscle fibers
combines with chloride and bicarbonate tor regulate acid-base balance
what is the normal range of sodium?
135- 145
more sodium taken in =
more sodium excrete through kidneys
if sodium intake is increased what else is?
extracellular fluid
what does ADH do?
cause kidneys to retain water –> diluting blood
what is excreted when sodium increase?
ADH
what is hypovolemic hyponatremia?
both sodium and water lever decrease in extracellular area
*Sodium loss > water loss
what are some non renal causes of hypovolemic hyponatremia?
vomit diarrhea fistulas gastric suctioning excessive sweating cystic fibrosis burns/wounds
what are some renal causes of hypovolemic hyponatremia?
osmotic diuresis
salt-losing nephritis
adrenal insufficiency
diuretic uses
what is sugnificant about diuretics being used?
it can cause potassium loss which lead to sodium loss
what is hypervolemic hyponatemia?
water and sodium increase in the extracellular area (Na levels diluted)
Water gain > sodium
what are some common causes of hypervolemic hyponateremia?
Heart failure Liver failure Nephrotic syndrome Excessive hypotonic IV fluids Hyperaldosteronism
what is isotonic hyponatremia?
sodium levels appear low because too much fluid is in the body.
what are some causes of isotonic hyponatremia?
glucocorticoid deficency
hypothyroidism
renal failure
SIADH
what is SIADH?
sydrome of inappropriate antidiuretic horomone cause excessive release of ADH –> excessive water retention
What does SIADH occur with?
cancer
CNS disorders
Pulmonary disorders
medications
what are some treatments for hyponatremia?
fluid restiriction
high-sodium diet
SEVERE: hypertonic IV solution
what are some thing you look for in a person with hyponatremia?
N/V
anorexia
neurological symptoms
what are some thing that effect what to look for in hyponatremia?
how fast the levels dropped
what are some neurological signs to look for in hyponatremia?
headach irritability dioriented twitching tremors weakness change in LOC
if severe hyponatremia what do you look for?
stupor delirium psychosis ataxia coma
what does low hyporvolemic hyponatremia show?
poor skin turgor dry cracked mucus membranes weak rapid pulses low B/P orthostatic hypotension CVP, PAP, and PAWP may decrease
what does hypervolemic hyponatremia show?
edema hypertension weight gain rapid bounding pulse CVP, PAP, PAWP elevate
what are some common diagnosis test with hyponatremia?
serum osmolarity < 280
serum Na less than 135
urine specific gravity < 1.010
elevated hematocrit and plasma protein
if a person is severe hyponatremia what do you do/look for?
hypertonic solution (infuse very slow and small volume)
monitor carefully for circulatory overload
worsening neurological status
nursing intervention for hyponatremia is?
VS neurological status daily weight skin turgor diagnostic tests often post sign of fluid restriction oral supplements IV treatment safe environment
what is the defense mechanism to hypernatremia?
hypothalmus –> thirst
who are more likely to experiance hypernatremia?
elderly patients, immobile patients, or unconscious patients and hypothalmas disorders
some athelets and infants too
what is hypernatremia?
excess sodium relative to water in the body
what some common sensible causes of hypernatremia?
vomiting
diarrhea
what are some insensible causes that relate to hypernatremia?
pulmonary infections
fever
heat stroke
what are some disease that increase risk of hypernatremia?
hyperosmolar
hyperglycemic nonketotic syndrome
diabetes (from lack of ADH)
what do you look for in hypernatremia?
N/V restlessness agitation anorexia weakness lethargy confusion stupor seizure coma low fever flushed skin elevated B/P bouning pulse dyspnea
what are some neromuscular signsa?
twitching
hyperreflexia
ataxia
tremors
what are some diagnotic test done associataed with hypernatremia?
serum sodium >145
urine specific gravity > 1.030
serum osmolality > 300
how do you treat hypernatremia?
oral replacement for water
IV fluids gradually over 48 hour
what are some nursing interventions with hypernatremia?
VS replacement --> response watch for cerebra edema and neurological change I&O daily weight assess skin --> breakdown, infection, & persiration oral hygeines safety
what foods are high in sodium?
canned soups and vegtables cheese ketchup processed meats table salts salty snacks seafood
