Na disorders
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| Hypervolemic Hypotonic Hyponatremia | Words: high volume, low tonicity, low Na. Labs: Osmolality: <280 mOsm (low), Na: <134 mEq/L (low) Associated with elevation fo ECF that is more than the elevation of Na. (confusing... | Total body Na excess: CHF, liver damage, nephrosis. Signs and symptoms: edema, weight gain, cerebral edema w/increased intracrainial pressure | correction of underlying disease, Na and water restriction, cautious use of loop diuretics, vasopressin receptor antagonits | --------------------
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| SIADH | A potential cause of Euvolemic Hypotonic Hyponatremia | Carcinomas (lung or pancreas), Pulmonary disorders, CNS (meningitis, stroke, tumor, trauma), medications (sulfonyureas SSRIs, TCA, NSAIDs +more) | water/fluid restriction (<1000mL/day), demeclocycline, phenytoin, and lithium, as well as hyperonic saline with Loops | --------------------
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| Euvolemic Hypotonic Hyponatremia | Words: Normal volume, low tonicity, low Na Labs: osmolality: <280 mOsm (low), Na: <134 mEq/L (low) Associated with: small increase in ECF volume, normal to slightly decreased total body Na, imbalances of water intake and extretion (the big one) | SIADH, H2O intoxication, renal faliure, K+ loss, medicaitons,and hypothyroidism | removal of causative agents, or treat underlying cause, if Na <110 mEq/L use hypertonic saline 3% used with diuretics (loops) | --------------------
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| Hypovolemic hypernatremia | Words: low volume, high Na decreased ECF and Na Associated with a eficit of water that is greater than the Na deficit. | Diarrhea and laxative induced, excessive sweating, diuretics, mannitol | restoration of intravascular volume (NS 200-300mL/h), replacewater deficit (D5W, or 1/2NS-replaced over 2-3 days) | decreased BP, decreased skin turgor, decreased HR
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| Hypervolemic Hypernatremia | Words: high volume, high Na Associated with an elevated ECF and high Na, the Na gain is greater than water gain | renal failure, iatrogenic (caused by treating hyponatremia),mineralcorticoid excess | replace water deficit D5W and 0.45NS and conjunction with diuretics | -------------------
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| Isotonic Hyponatremia | Word break down: equal tonicity and low Na. Labs: Osmolality-280 mOsm (normal) and Na <134 (low) Uncommon, mostly pseudohyponatremia- the Na isn't actually reduced but it will shift from the ECF to the ICF to maintain the osmolarity | Hyperlipidemia, hyperproteinema, isotonic infusion | Resolution of cause | --------------------
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| Hypertonic Hyponatremia | Words: elevated tonicity, low Na Labs: Osmolality: >280 mOsm (high), Na: <134 mEq/L (low) | Hyperglycemia (for every 100mg/dL increment of glucose over 200-serum Na decreases by 1.3-1.6mEq/L), hypertonic infusions (mannitol, glycine) | Resolution of cause | --------------------
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| Hypovolemic Hypotonic Hyponatremia | Words: low volume, low tonicity, low Na. Labs: Osmolality: <280 mOsm (low), Na: <134 mEq/L (low) Associated with Deficit of ECF volume and Deficit of Na is more than deficit of water | Diuretic use, profuse sweating, wound drainage, and burns, GI losses (vomiting/diarrhea), and renal tubular acidosis | Na and Water replacement: determine Na deficit | --------------------
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| Isovolemic Hypernatremia | Words: normal volume, high Na | water loss - diabetes insipidus, skin (fever), iatrogenic | targeted at replacing water deficit D5W or 0.45NS | --------------------
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