Sodium

Question 1

What is the normal ECF range for sodium?

Answer 1

135-145

Question 2

Sodium is responsible for_____

Answer 2

Water balance and Plasma Osmolarity

Question 3

Sodium Attracts _____

Answer 3

Chloride

Question 4

Sodium Sometimes exchanges for ____

Answer 4

Potassium

Question 5

Sodium assists with the _______

Answer 5

Acid-Base Balance

Question 6

What is the main function of sodium?

Answer 6

Promotes neuromuscular response and stimulates nerve and muscle fiber impulse transmission

Question 7

What is the number one regulator of sodium?

Answer 7

Kidney tubules

Question 8

During Hyponatremia, fluid shifts from the ____ to the ___ causing ___

Answer 8

ECF to the ICF causing edema

Question 9

During hyponatremia, edema can occur in the ____ causing ____ (this degrades nerves)

Answer 9

Brain (cerebral edema)

Demyelination

Question 10

What are three causes of ACTUAL hyponatremia?

Answer 10

Inadequate intake
Loss of body fluid
NPO

Question 11

What are three causes of relative hyponatremia?

Answer 11

Hyperglycemia
SIADH
irrigation with hypotonic fluids

Question 12

What are four drugs that cause a risk for hyponatremia?

Answer 12

Trycilic antidepressants
SSRI’s
Desmopression(ADH)
MDMA

Question 13

When assessing for hyponatremia, what is the main thing to look for?

Answer 13

Signs r/t nerve impulse transmission and muscle contraction

Question 14

What are three signs of decreased ECF?

Answer 14

Tachycardia, Hypotension
Pale dry skin
thirst

Question 15

What are two signs of increased ECF?

Answer 15

Hypertension w/bounding pulse

Edema and weight gain

Question 16

What are the 7 neuro signs of hyponatremia

DC SHAWL

Answer 16

Lethargy
Weakness
Headache
Confusion
Agitation
Dizziness
Seizures

Question 17

How does fluid volume effect the symptoms of hyponatremia?

Answer 17

they dont

Question 18

Hyponatremia will show a plasma sodium level below

Answer 18

135

Question 19

Serum osmolarity will ___ with hyponatremia

Answer 19

Drop

Question 20

The three interventions for hyponatremia?

Answer 20

Replacement
Monitoring
Restore Balance

Question 21

What are the types of replacement therapy for hyponatremia?

Answer 21

Oral (salt tabs or increased salt intake)

Parenteral (IV NaCl)

Question 22

How is Hyponatremia + Hypovolemia treated?

Answer 22

By correcting the ECF deficit

Question 23

When a pt is hyponatremic and hypervolemic, there is a sever risk for _____
How is this treated?

Answer 23

Cerebral edema

Treated with osmotic diuretics that pull water from the brain

Question 24

What drug is an osmotic diuretic?

Answer 24

Mannitol

Question 25

How is acute hyponatremia treated? What precautions should be taken?

Answer 25

With a hypertonic solution such as 3% NaCl | Should be given with a loop diuretic to avoid FVE

Question 26

3% NaCl should be given at a rate no greater than ____ to avoid ____

Answer 26

12 mEq/L/24hrs | Demylenation

Question 27

What happens to cells with hypernatremia? how does this effect the brain?

Answer 27

They shrink | It dries up

Question 28

What is the main effect of hypernatremia?

Answer 28

Increased Neurological activity

Question 29

What is the body's main response to hypernatremia?

Answer 29

Thirst

Question 30

What are 5 causes of ACTUAL hypernatremia?

Answer 30

``` Excessive ingestion Hyper Aldosteronism Corticosteroids Renal failure Wrong IV fluids ```

Question 31

What are 5 relative causes of hypernatremia?

Answer 31

``` NPO Increased metabolism Watery Diarrhea Hyperventilation Diabetes Incipits ```

Question 32

How does Hypernatremia effect the heart?

Answer 32

Tachy HTN Decreased contractibility

Question 33

How does hypernatremia affect the skin?

Answer 33

``` Dry Sticky Flushed Rough Dry tongue ```

Question 34

How does Hypernatremia effect the CNS?

Answer 34

increased irritability

Question 35

How does hypernatremia affect the GI system?

Answer 35

Watery Diarrhea Nausea Thirst

Question 36

With elevated sodium, _____ is also elevated

Answer 36

Chloride

Question 37

What medications should be avoided when the Patient has Hypernatremia

Answer 37

Medications that have sodium in them or medications that increase sodium retention

Question 38

What are the interventions for hypernatremia?

Answer 38

Decrease sodium intake Promote excretion Monitor Restore balance

Question 39

What drugs promote sodium excretion?

Answer 39

Loop and thiazide diuretics

Question 40

What is an important consideration when decreasing sodium levels?

Answer 40

Do slow to avoid cerebral edema

Question 41

When there is Hypernatremia that is euvolemic, what is the treatment?

Answer 41

Give water, identify the cause

Question 42

What is the treatment for Hypernatremia + Hypovolemia?

Answer 42

NS then D5W to balance

Question 43

What is the treatment for Hypernatremia + Hypervolemia?

Answer 43

Remove source of excess