Hyponatremia

Which of the following is most likely an intervention for fluid deficit (hypovolemic) hyponatremia? 1. Hypertonic Solution (3% or 5% NaCl) 2. Fluid Restriction 3. Dextrose 5% in Water (D5W)

1. Hypertonic Solution (3% or 5% NaCl); Patients with fluid deficit hyponatremia will often be given a small volume hypertonic solution such as 3% IV saline. These solutions increase the osmolarity of the plasma and shift fluid from the ICF to the ECF.

Which of the following findings is most likely to be seen in a patient with hyponatremia? Select all that apply 1. Nausea and Vomiting 2. Painful Muscle Cramps 3. Decreased LOC 4. Purpura 5. Seizures 5. Confusion / Lethargy

1. Nausea and Vomiting; Cerebral edema and increased intracranial pressure in brain tissue stimulate receptors in the brain causing nausea and vomiting. 3. Decreased LOC; Early signs of hyponatremia include decreased level of consciousness with severity of symptoms increasing as hyponatremia progresses. 5. Seizures; Both hyponatremia and hypernatremia may result in seizures and eventually coma as neuromuscular synapses are unable to fire appropriately. A severe manifestation results in coma. 6. Confusion / Lethargy; Confusion and lethargy are often associated with decreased level of consciousness attributed to decreased excitability of CNS tissues due to decreased sodium levels. Always assess the patient's history to establish a baseline normal level of functioning. Check for a medical alert bracelet on the patient for the possibility of diabetes.

Which of the following is a priority intervention for hyponatremia? Select all that apply 1. Reduce Diuretic Dosage 2. Bleeding Precautions 3. Insulin 4. Assess Airway

1. Reduce Diuretic Dosage; Loop and thiazide diuretics can precipitate hyponatremia as well as low levels of other body electrolytes. A health care provider may reduce their dosages. 4. Assess Airway; Decreased muscle strength often manifests as decreased or absent deep tendon reflexes. Any patient with muscle weakness should have their airway status monitored. Patients with decreased LOC also are at risk for aspiration.

Sodium (Na+) normal range

135-145 mEq/L

Which of the following is most likely an intervention for fluid excess (hypervolemic) hyponatremia? Select all that apply 1. Hydrochlorothiazide HCTZ 2. Mannitol (Osmitrol) 3. Calcium Citrate 4. Fluid Restriction

2. Mannitol (Osmitrol); Patients with fluid excess, especially exhibiting signs of increased intracranial pressure are given Mannitol (Osmitrol), an osmotic diuretic which causes excretion of only free water. This medication decreases fluid volume and results in increased osmolarity of the plasma. 4. Fluid Restriction; Some patients may be placed on a fluid restriction. Patients with psychogenic polydipsia are often given this treatment.

Which of the following is the most appropriate criterion for evaluating the presence of hyponatremia in a patient? 1. < 140 mEq Na+ 2. < 120 mEq Na+ 3. < 125 mEq Na+ 4. < 135 mEq Na+

4. < 135 mEq Na+; Less than 135mEq/L is considered low in a normal adult patient. The normal range is generally 135-145 mEq/L.

What is hyponatremia normal levels?

A serum sodium level less than 135 mEq/L. Sodium imbalances are usually with fluid imbalances. Normal levels are 135 mEq/L to 145 mEq/L

What is Hyponatremia?

Hyponatremia Hyponatremia is a low serum sodium level less than 135 mEq/L. This causes a shift of fluid volume from the extracellular fluid to the intracellular fluid resulting in cellular swelling and reduced excitable depolarization of cells. Many things may cause precipitate hyponatremia including actual sodium deficits or relative sodium deficits. Some relative causes include water intoxication (water excess) which results in a hypoosmolar imbalance. An additional assessment is done to determine if the patient has hyponatremia related to fluid overload or a fluid deficit, as these conditions manifest slightly differently.

common food sources of sodium

bacon butter canned food cheese cured pork frankfurters hot dogs ketchup lunch meat milk mustard processed food snack food soy sauce table salt white and whole wheat bread