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16 Cards in this Set

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  • Back
Signs and symptoms of hyponatremia?
Headache
Confusion
Seizures
Causes of hyponatremia?
Increased prerenal sodium and water reabsorption (CHF, cirrhosis)
Excessive sodium loss (vomiting, diarrhea, nephrosis, diuretics, osmotic diuresis, adrenocortical insufficiency)
Psychogenic polydypsia
Inappropriate secretion of ADH
Pseudohyponatremia
What is the correction of sodium for hyperglycemia?
1.6-1.8 mEq/L per 100 mg/dL
What is the complication of rapid correction of hyponatremia?
Central pontine myelinolysis
What are the symptoms of central pontine myelinolysis?
Fluctuating level of consciousness
Behavioral changes
Dysarthria
Dysphagia
Seizures
Leads to pseudobulbar palsy and quadriparesis
What rate of correction can cause central pontine myelinolysis?
>0.6 mEq/L/hr or >25 mEq/48 hrs if hyponatremia >2 days

>2.5 mEq/L/hr if hyponatremia <2 days
How do you estimate a sodium deficit?
Na+ needed = 0.6(%TBW) x wt.(kg) x 140-actual serum Na+ in mEq/L
What are two causes of pseudohyponatremia?
Multiple myeloma
Hyperlipidemia
What are four causes of hypovolemic hyponatremia with high renal sodium loss (>20 mEq/L)?
Diuretics
Mineralcorticoid deficiency
Salt-wasting nephropathy
Osmotic diuresis (hyperglycemia, mannitol)
What are six causes of hypovolemic hyponatremia with low renal sodium loss (<10 mEq/L)?
Excessive sweating
Vomiting
Diarrhea
Fistula
"Third space"
Traumatized muscle
What is the most common cause of hypovolemic hyponatremia in children?
Viral gastroenteritis causing vomiting and diarrhea replaced with free water
What is the treatment of hypovolemic hyponatremia?
Isotonic saline
What are some causes of euvolemic hyponatremia?
Endocrine (hypothyroidism, glucocorticoid deficiency, SIADH)
Non-endocrine (pain, drugs, psychogenic water drinker)
What is the treatment of less severe cases of euvolemic hyponatremia? More severe cases?
Water restriction

Hypertonic saline or furosemide plus saline
What is the cause of hypervolemic hyponatremia with high renal sodium loss (>20 mEq/L)?
Acute renal failure

Chronic renal failure
What are some causes of hypervolemic hyponatremia with low renal sodium losses (<10 mEq/L)?
Nephrotic syndrome
Hepatic cirrhosis
CHF