BSN Notes: Common Signs And Symptoms: Hyponatremia

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SODIUM IMBALANCES
·         Sodium is a main cation of the ECF, plays important role in maintaining the concentration and volume of the ECF.
·         It Is the primary determinant of ECF osmotality.
·         Generation and transmission of nerve impulses and regulation of acid base balance.  
·         The normal serum sodium level is 135-145 mEq/L
·         Intake - GI tract absorbs sodium from food.
·         Sodium excretion - Through urine, sweat and faces.
HYPONATREMIA
·         It is defined as a plasma sodium level less than 135mEq/L.
·         Most common electrolyte disorder in older adults.
·         Is usually associated with changes in fluid volume status.
Causes
1.Excessive sodium loss:
·         GI losses: Diarrhea, Vomiting, Fistulas, NG suction.
·         Renal losses: Diuretics, adrenal insufficiency, Sodium wasting renal disease
·         Skin losses: Burns, wound drainage
2.Inadequate sodium intake: Fasting
3.Excessive water gains: Excessive hypotonic IV fluids.
4.Disease states: SIADH, heart failure, Primary hyperaldosteronism.
CLINICAL MANIFESTATIONS
CNS Manifestations
·         Headache, Confusion
·         Hallucinations, Behavioral changes
·         Seizures, Coma and death CVS Manifestations
·         Decrease in BP, Orthostatic hypotension, Weak and thready pulse 
·         In severe hypovolemic hypernatremia, a shock like state occurs.
Respiratory
·         Tachypnea, dyspnea, Orthopnea, feeling short of breath, Crackles , Cheyne-stocks respiration     
·         Neurogenic hyperventilation
Gastro Intestinal
·         Nausea, Vomiting, Hyperactive bowel sounds, Abdominal cramping, Diarrhea.
Other features
·         Dryness of skin, mucous membrane and tongue.

MEDICAL MANAGEMENT
·         If sodium levels of 126-135 mEq/L: Add additional salt in diet, Fluids restricted.
·         Below 125mEq/L: IV sodium replacement with Normal saline
·         115mEq/L or less: Concentrated saline solution such as 3% NaCl is indicated until the plasma concentration reaches 125 mEq/L .
NURSING MANAGEMENT
Diagnosis
·         Risk for injury related to altered sensorium & decreased level of consciousness secondary to abnormal CNS function.

 Potential complications: severe neurologic changes.

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notes.nursium.com: BSN Notes: Common Signs And Symptoms: Hyponatremia
BSN Notes: Common Signs And Symptoms: Hyponatremia
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