Sodium Imbalances Flashcards

1
Q

What is the expected lab range for Sodium?

A

Na+= 135/145

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2
Q

Is Sodium found in the intracellular or extracellular spaces?

A

Na+ is the “Major” extracellular cation

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3
Q

what ion governs osmolarity?

A

Na+

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4
Q

What ion initiates action potentials?

A

Na+

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5
Q

What is hypernatremia?

A

too much Na+

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6
Q

What is hyponatremia?

A

too little Na+

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7
Q

What is a hypertonic solution?

A

An IVF that is greater than 0.9%

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8
Q

Do you need to hydrate a patient on tube feed?

A

Yes, give them 500 mL of free water per shift to prevent dehydration, hypernatremia

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9
Q

Causes for hypernatremia

A
  • Inadequate intake**
  • Excess water loss–insensible water loss
    (breathing, sweat), diarrhea, osmotic diuretics
  • Excess sodium intake–hypertonic IVF, tube feed
    without free water
    -Disease
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10
Q

Diseases that cause hypernatremia?

A
  • Diabetes mellitus, uncontrolled
  • Diabetes insipidus
  • Cushing syndrome
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11
Q

Causes for hyponatremia

A
  • Inadequate sodium intake
  • Excess sodium loss
    - renal (diuretics), GI losses
    - skin losses (burns, wounds)
  • Excess water gain that lowers Na+ concentration
    - Excess hypotonic IVF
  • Disease
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12
Q

Diseases that cause hyponatremia?

A
  • SIADH
  • Heart failure
  • Kidney failure
  • Cirrhosis
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13
Q

Manifestations of hypernatremia

A

Cellular shrinkage that cause changes in mental status:
-Headache, irritability, difficulty concentrating,
confusion, seizures, coma
If they also have ECF volume deficit:
-Postural hypotension, tachycardia & weakness

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14
Q

Nursing care for hypernatremia

A

Depends on cause:

  • If water loss is cause, add water
  • If sodium excess is cause, remove sodium
  • Monitor serum sodium/osmolality
  • Gradually achieve normal sodium level over a 48 hours period to avoid edema of cerebral cells
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15
Q

Why do we correct Na+ imbalances slowly?

A

We correct imbalances over a 48 hour period to avoid causing cerebral edema

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16
Q

Nursing care for hyponatremia

A
  • If mild, restrict fluids & loop diuretics
  • If acute, small amounts of IV hypertonic NS (3%)
  • Avoid rapid correction (correct over 24 -48 hours)
  • Provide safe environment, seizure precautions PRN
17
Q

Manifestations of hyponatremia

A

Cellular swelling that causes change in mental status
-Drowsy, restless, confused, lethargy, seizures, coma
If they also have ECF volume excess:
-Weight gain & increased BP