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Sodium Imbalances
| Question | Answer |
|---|---|
| Serum Na+ levels < 135 mEq/L | Hyponatremia |
| Normal lab values for Na+ | 135-145 mEq/L |
| What causes Hyponatremia | Loss of Na+ from the body(renal losses,extrarenal losses)and FVE resulting in Na+ dilution (CHF, Renal Failure, Cirrhosis) |
| What are Signs & Symptoms of Hyponatremia with serum levels > 125 mEq/L | Altered GI function -Anorexia -Abdominal cramping -Nausea, vomiting -Diarrhea |
| What are Sings & Symptoms of Hyponatremia as Na+ levels fall below 120 mEq/L | Neurologic changes: -Headache -Altered mental status -Muscle twitching -Convulsions,coma |
| What urine test helps id the cause of Na+ deficit | 24-hour urine test |
| Hyponatremia lab values | Serum Na+ < 135 mEq/L Osmolality < 270 mOmsm/kg |
| Treament for client with hyponatremia for FVD or normal fluid balance | FV replacement with Na+ (PO,NGT,or IV) |
| Treament for client with hyponatremia for FVE or Na+ dilution | Restrict fluids Administer diuretic per order |
| Clients at risk for Hyponatremia | Athletes, children, and elderly |
| Causes of Hypernatremia | Water loss or Na+ Gain: -Decreased oral intake -High fever -Chronic diarrhea -Increased respiratory rate -Tube feeding -Hypertonic IV solutions |
| What are Signs & Symptoms of Hypernatremia | Neurological changes(disorientation,confusion,lethargy,restlessness,muscle weakness) Thirst Edema Hypertension |
| Lab values for Hypernatremia | Serum Na+ > 145 mEq/L Osmolality > 300 mOsm/kg |
| Treament for Hypernatremia | -Prevention -PO or IV Na+ replacement -Diuretics -Low-Na+ diet **** Corrections must be done SLOWLY!**** |
| Nursing care for clients with Hypernatremia | Identify clients at risk |
| Nursing Diagnosis for Hypernatremia | Risk for Injury -PRIORITY: pay attention to neurological function -Monitor lab values -Institute safety precautions -Monitor/maintain PO & IV fluids |
| Client teaching for clients with Hypernatremia | -Low Na+ diet -Read food labels -Medications high in Na+ (Corticosteroids) -Alternatives to Na+ & substitutes (herbs,spices) |
| Serum Na+ levels > 145 mEq/L | Hypernatremia |
| Teaching for clients with Hyponatremia | Signs & Sypmtoms of mild hyponatremia and when to increase fluids containing Na+ and other electrolytes |
Created by:
sdysart
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