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16 Cards in this Set
- Front
- Back
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Signs and symptoms of hyponatremia?
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Headache
Confusion Seizures |
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Causes of hyponatremia?
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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 |
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What is the correction of sodium for hyperglycemia?
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1.6-1.8 mEq/L per 100 mg/dL
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What is the complication of rapid correction of hyponatremia?
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Central pontine myelinolysis
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What are the symptoms of central pontine myelinolysis?
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Fluctuating level of consciousness
Behavioral changes Dysarthria Dysphagia Seizures Leads to pseudobulbar palsy and quadriparesis |
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What rate of correction can cause central pontine myelinolysis?
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>0.6 mEq/L/hr or >25 mEq/48 hrs if hyponatremia >2 days
>2.5 mEq/L/hr if hyponatremia <2 days |
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How do you estimate a sodium deficit?
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Na+ needed = 0.6(%TBW) x wt.(kg) x 140-actual serum Na+ in mEq/L
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What are two causes of pseudohyponatremia?
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Multiple myeloma
Hyperlipidemia |
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What are four causes of hypovolemic hyponatremia with high renal sodium loss (>20 mEq/L)?
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Diuretics
Mineralcorticoid deficiency Salt-wasting nephropathy Osmotic diuresis (hyperglycemia, mannitol) |
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What are six causes of hypovolemic hyponatremia with low renal sodium loss (<10 mEq/L)?
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Excessive sweating
Vomiting Diarrhea Fistula "Third space" Traumatized muscle |
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What is the most common cause of hypovolemic hyponatremia in children?
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Viral gastroenteritis causing vomiting and diarrhea replaced with free water
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What is the treatment of hypovolemic hyponatremia?
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Isotonic saline
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What are some causes of euvolemic hyponatremia?
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Endocrine (hypothyroidism, glucocorticoid deficiency, SIADH)
Non-endocrine (pain, drugs, psychogenic water drinker) |
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What is the treatment of less severe cases of euvolemic hyponatremia? More severe cases?
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Water restriction
Hypertonic saline or furosemide plus saline |
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What is the cause of hypervolemic hyponatremia with high renal sodium loss (>20 mEq/L)?
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Acute renal failure
Chronic renal failure |
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What are some causes of hypervolemic hyponatremia with low renal sodium losses (<10 mEq/L)?
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Nephrotic syndrome
Hepatic cirrhosis CHF |
