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Lewis Chap 17
hyponatremia/hypernatremia pg. 325
| Question | Answer |
|---|---|
| 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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