Hyponatremia Lecture Notes

Introduction

• Presenter: Sarah from Register Nurse RN
• Video covers:
  • Types of Hyponatremia
  • Signs and Symptoms
  • Causes
  • Nursing Interventions
• Recommendation: Take the quiz on RegisterNurseRN.com

Understanding Hyponatremia

• Hyponatremia: Low sodium in the blood
• Normal Sodium Levels: 135-145 mEq/L
• Sodium regulates water balance in the body (intracellular & extracellular)
• Water follows sodium (osmosis)

Types of Hyponatremia

1. Euvolemic Hyponatremia

   • Water increases; sodium stays the same
   • No edema observed
   • Causes: SIADH, Diabetes Insipidus, Adrenal Insufficiency

2. Hypovolemic Hyponatremia

   • Dehydration; loss of blood volume
   • Decrease in sodium and water
   • Causes: Vomiting, diarrhea, NG suction, diuretic therapy, burns, excessive sweating

3. Hypervolemic Hyponatremia

   • Both water and sodium increase
   • Fluid volume overload; sodium diluted
   • Causes: CHF, Kidney failure, excessive saline infusion, liver failure

Mnemonic for Causes

• NO Na+
  • N: Sodium excretion increased (renal problems, NG suction, vomiting, diuretics)
  • O: Overload of fluids (CHF, hypotonic solutions)
  • Na: Low sodium intake
  • A: Anti-diuretic hormone over secreted (SIADH)

Signs and Symptoms (Mnemonic: SALT LOSS)

• S: Seizures and stupor
• A: Abdominal cramping, attitude changes (confusion)
• L: Lethargy
• T: Tendon reflexes diminished, trouble concentrating
• L: Loss of urine and appetite
• O: Orthostatic hypotension, overactive bowel sounds
• S: Shallow respirations (late sign)
• S: Spasms of muscles

Nursing Interventions

• Monitor: Cardiac, respiratory, neuro, renal, GI status
• Hypovolemic Hyponatremia
  • Administer 3% saline (hypertonic solution)
  • Monitor for fluid volume overload
• Hypervolemic Hyponatremia
  • Fluid restriction
  • Possible diuretics
  • Dialysis if renal failure
• SIADH Treatment
  • Fluid restriction
  • Anti-diuretic hormone antagonist (Declomycin)
  • Avoid dairy and antacids
• Lithium Considerations
  • Monitor lithium levels due to sodium level impact
• Dietary Advice
  • Consume sodium-rich foods
  • Examples: Bacon, butter, canned foods, cheese, hot dogs, lunch meat, processed foods, table salt

Conclusion

• Check out more videos on electrolyte imbalances
• Take the quiz on hyponatremia and hypernatremia differences
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