Hyponatremia Lecture Notes

Introduction

• Presented by Sarah from RegisteredNurseRN.com
• Covers:
  • Types of hyponatremia
  • Signs and symptoms
  • Causes
  • Nursing interventions
  • Mnemonics for memory aids
• Reminder to take the free quiz on the website.

Understanding Hyponatremia

• Definition: Low sodium levels in blood.
• Normal Sodium Levels: 135-145 mEq/L.
• Role of Sodium:
  • Regulates water in and out of cells.
  • Sodium and water move together.
  • Imbalance affects osmosis and cell function.

Types of Hyponatremia

1. Euvolemic Hyponatremia

   • Water increases, sodium remains the same.
   • No edema; sodium appears diluted.
   • Causes: SIADH, diabetes insipidus, adrenal insufficiency.

2. Hypovolemic Hyponatremia

   • Dehydration from loss of blood and sodium.
   • Causes: Vomiting, diarrhea, NG suction, diuretics, burns.

3. Hypervolemic Hyponatremia

   • Increase in both water and sodium, leading to fluid overload.
   • Sodium becomes diluted.
   • Causes: CHF, kidney failure, saline infusion, liver failure.

Mnemonic for Types of Hyponatremia

• NO SODIUM:
  • N: Sodium excretion increased
  • O: Overload of fluids
  • N: Low sodium intake
  • A: Over-secretion of ADH

Signs and Symptoms

• Mnemonic: SALT LOSS
  • S: Seizures and stupor
  • A: Abdominal cramping, attitude changes
  • L: Lethargy
  • T: Tendon reflexes diminished
  • L: Loss of urine and appetite
  • O: Orthostatic hypotension, overactive bowel sounds
  • S: Shallow respirations
  • S: Spasms of muscles

Nursing Interventions

• Monitor cardiac, respiratory, neuro, renal, and GI status.

• Hypovolemic Hyponatremia:

  • Administer hypertonic saline (3% saline solution).
  • Caution: Risk of fluid overload.
  • Preferably administered in ICU.

• Hypervolemic Hyponatremia:

  • Restrict fluids.
  • Use of diuretics or dialysis if needed.

• SIADH:

  • Restrict fluids.
  • Use ADH antagonist (e.g., Declomycin).
  • Avoid dairy and antacids with Declomycin.

• Monitor patients on lithium for drug levels.

• Dietary Suggestions:

  • Encourage sodium-rich foods: bacon, butter, canned foods, cheese, hot dogs, lunch meat, processed foods, table salt.

Conclusion

• Important to understand both hypernatremia and hyponatremia.
• Check the YouTube channel and website for more resources and quizzes.