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Lewis Chap 17

hyponatremia/hypernatremia pg. 325

QuestionAnswer
Hyponatremia GI causes sodium loss d,v,f,n diarrhea, vomiting, fistulas, NG suction
Hyponatremia Renal causes sodium loss d,a,n,r diurectics, adrenal insufficiency, Na+ wasting renal diseases
Hyponatremia skin causes sodium loss b,w burns, wound drainage
Hyponatremia from inadequate sodium intake fasting diets
Hyponatremia caused from excessive water gain excessive hypotonic IV fluids, primary polydipsia
Hyponatremia caused from diseases s,h,p SIADH (syndrome of inappropriate antidiuretic hormone hypersecretion), heart failure, primary hypoaldosteronism
Hyponatremia with decreased ECF volume S/S i,a,c,d,p,t,s,c,d,p,cvp,jvf,t,t,c irritability, apprehension, confusion, dizziness, personality changes, tremors, seizures, coma, dry mucous membranes, postural hypotension, ↓CVP, ↓juglar venous filling, tachycardia, thready pulse, cold clammy skin
Hyponatremia with normal/increased ECF volume S/S h,a,c,m,s,c,n,v,d,a,w,bp,cvp headache, apathy, confusion, muscle spasms, seizures, coma, nausea, vomiting, diarrhea, abdominal cramps, weight gain, ↑BP, ↑CVP
Hypernatremia from excessive sodium intake IV fluids: hypertonic NaCl, excessive isotonic NaCl, IV sodium bicarbonate, hypertonic tube feedings w/o water supplements, near drowning salt water
Hypernatremia from inadequate water intake unconscious or cognitively impaired individuals
Hypernatremia from excessive water loss ↑insensible water loss (high fever, heatstroke, prolonged hyperventilation), osmotic diuretic therapy, diarrhea
Hypernatremia from disease diabetes insipidus, primary hyperaldosteronism, cushing syndrome, uncontrolled diabetes mellitus
Hypernatremia with decreased ECF volume S/S restlessness, agitation, twitching, seizures, coma, intense thirst, dry, swollen tongue, sticky mucous membranes, postural hypotension, ↓CVP, weight loss, weakness, lethargy
Hypernatremia with normal/increased ECF volume S/S restlessness, agitation, twitching, seizures, coma, intense thirst, flushed skin, weight gain, peripheral and pulmonary edema, ↑BP, ↑CVP
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