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Understanding Hyponatremia and Its Management

Apr 16, 2025

Hyponatremia Lecture Notes

Overview

  • Presenter: Sarah from Register Nurse RN
  • Topic: Hyponatremia
  • Previous Video: Covered hypernatremia
  • Quiz: Available at registernursrn.com

Understanding Hyponatremia

  • Hyponatremia Definition: Low sodium in the blood
    • Normal Sodium Level: 135-145 mEq/L
    • Hyponatremia: Sodium levels < 135 mEq/L
  • Role of Sodium:
    • Regulates water in cells (intracellular and extracellular)
    • Water follows sodium due to osmosis
    • Low sodium = cells swell (can burst)

Types of Hyponatremia

  1. Euvolemic Hyponatremia
    • Increased water, sodium stays the same
    • No edema
    • Causes: SIADH, diabetes insipidus, adrenal insufficiency
  2. Hypovolemic Hyponatremia
    • Dehydration, decreased sodium and water
    • Causes: Vomiting, diarrhea, NG suction, diuretics, burns, sweating
  3. Hypervolemic Hyponatremia
    • Increased water and sodium, fluid overload
    • Causes: CHF, kidney failure, excessive saline, liver failure

Mnemonics

  • No Sodium (NA):
    • N: Sodium excretion increased (renal issues)
    • O: Overload of fluids (CHF, liver failure)
    • N: Low sodium intake
    • A: ADH over-secreted (SIADH)

Signs and Symptoms (SALT LOSS)

  • S: Seizures and stupor
  • A: Abdominal cramping, attitude changes
  • 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, and GI status
  • Hypovolemic Hyponatremia:
    • Administer IV sodium solution (3% saline)
    • Given slowly in a monitored setting (ICU)
  • Hypervolemic Hyponatremia:
    • Fluid restriction
    • Possible diuretics
    • Dialysis for renal failure
  • SIADH Treatment:
    • Fluid restriction
    • ADH antagonist (e.g., Declomycin)
    • Avoid food interactions with Declomycin (dairy, antacids)

Additional Considerations

  • Lithium: Check levels if patient is on lithium
  • Diet: Encourage sodium-rich foods (bacon, butter, canned foods, cheese)
  • Test Tips: Be aware of tricky foods with hidden sodium

Conclusion

  • Recommendation: Watch other electrolyte imbalance videos
  • Action: Take the quiz on hyponatremia and hypernatremia differences
  • Subscription: Consider subscribing to the YouTube channel

Full transcript