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NP exam: Fluid and electrolyte balance 2024/2025 Questions With Completed & Verified Solutions.
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NP exam: Fluid and electrolyte balance 2024/2025 Questions With Completed & Verified Solutions.
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NP exam: Fluid and electrolyte balanceHyponatremia - ANS Low sodium. Most common electrolyte abnormality
Urine sodium - ANS Normal is 10-20 mEq/l
Serum osmolality - ANS Usually 2x Na (275-295)
Urine sodium greater than 20 mEq/l - ANS Suggests salt wasting, a problem with the kidneys,
intrarenal kidney disease
Urine sodium less than 10 mEq/l - ANS suggests renal retention of sodium to compensate for
extrarenal fluid losses - not a problem in the kidneys - postrenal kidney disease
Isotonic Hyponatremia - pseudohyponatremia - ANS Serum osmolality 284-295
Occurs with extreme hyperlipidemia or hyperproteinemia
Body water is normal and patient is asymptomatic
Treatment: Cut down fat
No fluid restriction
Hypotonic Hyponatremia - ANS state of body water excess diluting all body fluids, clinical signs
arise from water EXCESS
Serum osmolality less than 280
Hypotonic hyponatremia - ANS Hypovolemic with Urine NA less than 10
-Dehydration
-Diarrhea
-Vomiting
Hypovolemic with Urine NA greater than 20 (low volume and kidneys cannot conserve Na)
-Diuretics
-ACE inhibitors
-mineralocorticoid deficiency
Hypervolemic (need to restrict water)
-Edematous states
-CHF
-Liver disease
-advanced renal failure
HYPERtonic Hyponatremia - ANS Serum Osmo greater than 290
Hyperglycemia (often from HHNK)
Osmolality is high but Na is low
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