Sodium Imbalances Flashcards
What is the expected lab range for Sodium?
Na+= 135/145
Is Sodium found in the intracellular or extracellular spaces?
Na+ is the “Major” extracellular cation
what ion governs osmolarity?
Na+
What ion initiates action potentials?
Na+
What is hypernatremia?
too much Na+
What is hyponatremia?
too little Na+
What is a hypertonic solution?
An IVF that is greater than 0.9%
Do you need to hydrate a patient on tube feed?
Yes, give them 500 mL of free water per shift to prevent dehydration, hypernatremia
Causes for hypernatremia
- Inadequate intake**
- Excess water loss–insensible water loss
(breathing, sweat), diarrhea, osmotic diuretics - Excess sodium intake–hypertonic IVF, tube feed
without free water
-Disease
Diseases that cause hypernatremia?
- Diabetes mellitus, uncontrolled
- Diabetes insipidus
- Cushing syndrome
Causes for hyponatremia
- 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
Diseases that cause hyponatremia?
- SIADH
- Heart failure
- Kidney failure
- Cirrhosis
Manifestations of hypernatremia
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
Nursing care for hypernatremia
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
Why do we correct Na+ imbalances slowly?
We correct imbalances over a 48 hour period to avoid causing cerebral edema
