Exam (elaborations)
NURS6902 SODIUM TEST
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NURS6902 SODIUM TESTSodium - ANSWER The chief electrolyte in the ECF; total body sodium is
proportional to volume status; so increased sodium = increased water = increased
intravascular volume
Hyponatremia - ANSWER Serum sodium less than 135 mmEq; most commonly d/t
excess free H2O, can be caused by excess Na
Most common electrolyte imbalance - ANSWER Hyponatremia
What should you evaluate in hyponatremia? - ANSWER 1. Urine sodium, 2. Serum
osmolality, 3. Clinical status
Isotonic hyponatremia - ANSWER Lab artifact d/t high triglycerides
Hypotonic hyponatremia - ANSWER LOW SERUM OSMOLALITY; low sodium
due to water excess
Hypotonic hyponatremia with HYPOVOLEMIA and urine sodium <10mEq -
ANSWER Caused by dehydration; puking and pooping out all of their sodium
Hypotonic hyponatremia with HYPOVOLEMIA and urine sodium sodium
>20mEq - ANSWER Low volume and kidneys can't conserve sodium; caused by
diuretics, decreased aldosterone (Na is excreted while K+ is retained)
Hypervolemic hypotonic hyponatremia - ANSWER Low sodium, low tonicity and
increased volume — sodium is diluted; due to fluid volume excess —> excess IVF,
psychogenic polydipsia, CHF, liver diseas, ARF, SIADH
Hypertonic hyponatremia - ANSWER Serum osmolality >290; loss of sodium but
high osmolality due to high glucose in the blood; think DKA
Signs symptoms of hyponatremia - ANSWER Lethargy, confusion, muscle
weakness, decreased deep tendon reflexes, diarrhea, respiratory symptoms (LATE)
Acute hyponatremia - ANSWER Should be treated acutely, within 24-48 hours
Chronic hyponatremia - ANSWER Can be corrected slowly
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