Fluid Electrolyte imbalance: Sodium

Sodium

135-145 mEq/L

Function: PULLS or Attracts WATER

Hyponatremia

Values:

< 130

Causes:

·         Excess sodium loss or weight gain

Signs and symptoms:

·              Hypotension

·              Confusion

·              Headache

·             Lethargy

·              Seizures

·              Decreased muscle tone

·              Muscle twitching and tremors

·              Vomiting

·             Diarrhea

·              Cramps

Treatment:

       Mild: Water restriction if water  retention problem;  

       Increase sodium if there is loss of Sodium

       Moderate:  IV 0.9% NS, 0.45% NS, LR

       Severe: 3% NS – short term Therapy in ICU setting

Hypernatremia

Values:

        Deprivation of water, hypertonic tube feedings     

        without food supplements, watery diarrhea, greatly

        increases insensible water loss, renal failure,

        inadequate blood circulation to kidneys, use of large

        doses of adrenal corticoids, excess sodium intake

Causes:

        Early:  generalized muscle weakness, faintness,

       muscle fatigue, HA

        Moderate:  Confusion, thirst

        Late:  Edema, restlessness, thirst, hyperreflexia,

        muscle twitching, irritability, seizures, possible coma

        Severe:  Permanent brain damage, HPN,

        tachycardia,      N&V

Signs and symptoms:

·         Free water to replace ECF volume

·         Gradual lowering with hypotonic saline (decreased by no more than 2 meq/L/hr)

·         Offer fluids at regular interval

·         Supplement tube feedings with free water

·         Teach about foods, medications high in Sodium

·         Treat underlying problem

Treatment:

     Deprivation of water, hypertonic tube feedings

     without food supplements, watery diarrhea, greatly

     increases insensible water loss, renal failure,

     inadequate blood circulation to kidneys, use of large

     doses of adrenal corticoids, excess sodium intake