Week 9 - Lab Values - Sodium

Question 1

What are the two main characteristics of sodium?

Answer 1

• the most abundant extracellular cation

* controls water distribution and fluid balance

Question 2

What are the 4 functions of sodium? hint 2 maintains and 2 promotes.

Answer 2

• maintain body fluids
• maintain systemic blood pressure
• promote transmission of nerve impulses
• promote muscle contractility

note:
- contributes to osmotic pressure (where Na+ goes, H2O follows); controls thirst mechanism (when eat Na+ rich meal, want H2O to dilute blood Na+)
- pulls H2O out of cells to help ↑ blood volume, ↑ BP

Question 3

What are the two different types of hyponatremia?

Answer 3

hyponatremia due to hypervolemia

hyponatremia due to loss of Na+ and H2O

Question 4

What are the possible causes of hyponatremia d/t hypervolemia?

Answer 4

excess H2O intake or IV fluid therapy

Question 5

What are the characteristics of hyponatremia d/t hypervolemia?

Answer 5

bounding pulses, high blood pressure, tachycardia

jugular vein distention (veins popped out)

Question 6

Goal to treat hyponatremia d/t hypervolemia?

Answer 6

Water intake may be restricted or stop IV fluids if hypervolemia is d/t IV fluids

Question 7

What are the possible causes of hyponatremia d/t loss of Na+ and H2O? (hypovolemic hyponatremia)

Answer 7

excessive sweating and diaphoresis (severe fevers can cause dehydration), excessive vomiting and diarrhea, significant blood loss, GI suction (nasogastric suction in stomach), certain drugs, lirke furosemide

Question 8

What are the characteristics of hyponatremia d/t loss of Na+ and H2O?

Answer 8

decreased blood pressure, tachycardia, weak pulses,

Question 9

Goal to treat hyponatremia d/t loss of Na+ and H2O?

Answer 9

Increasing Na+ intake with loss of Na+ through IV fluids or diet

Question 10

If there is a low blood pressure due to low fluid volume d/t hypovolemia, what are some other characteristics that could also be effected?

Answer 10

decreased urine output, poor cap refill, dry mouth, perfusion to critical organs like kidneys and heart

Question 11

Early symptoms of hyponatremia

Answer 11

headache, nausea, vomiting, anorexia (↓ appetite), abdominal cramping

Question 12

Later signs of hyponatremia

Answer 12

confusion, lethargy, muscle twitching, seizures (severe), possibly coma (severe)

Question 13

What are the nursing implications for hyponatremia?

Answer 13

• use of analgesics and antiemetics (controls s/sx)
• neurological assessment (maintaining baseline or improving from baseline)
• implement fall and seizure precautions (NO order needed to implicate fall precautions - MD will order seizure pads)
• assess blood pressure and heart rate (improving from baseline)
• monitor intake and output (kidneys → holding on to volume)

Question 14

What are the hypernatremia values?

Answer 14

Anything greater than 145 mEq/L

Question 15

What are the causes of hypernatremia?

Answer 15

excess Na+ intake and fluid volume deficient (loss of fluid volume [H2O])

Question 16

What are the symptoms of hypernatremia?

Answer 16

muscle twitching, restlessness, lethargy, decreased LOC, decreased cardiac output (↓ fluid volume = ↓ cardiac output), and hypovolemic s/sx (↓ BP = effects organs, ↓urine output, skin turgor)

Question 17

What are the nursing implications for hypernatremia?

Answer 17

• neurological assessment (restless, confused, lethargic)
• assess perfusion (cap refill)
• monitor I + O (kidney + ♥ need blood volume → will keep →no water for urine = dark, amber colored)
• assess mucus membranes and VS (dry membranes)

Question 18

What type of diet intervention would be needed for a patient with hypernatremia?

Answer 18

Low sodium diet, use of Mrs Dash, Lemon, Pepper, and Herbs to dress meals