§ A condition that occurs when the level § Deficient ECF volume
in the blood is too low (less than 136 § Excessive GI lo sses: vomiting, nasogastric
losses:
mEq/L) suctioning, diarrhea, tap water enemas
§ Results from an excess of water in the § Renal losses: diuretics, kidney disease, adrenal
insufficiency, excessive sweating
plasma or loss of sodium-rich fluids
§ Skin losses: burns, wound drainage,
§ Hyponatremia delays and slows the gastrointestinal obstruction, peripheral
depolarization of membranes edema, ascites
§ Water moves from the ECF into the ICF, § Increa
ncreased
sed or normal ECECFF volume: excessive
volume:
which causes cells in the brain and oral water intake, syndrome of inappropriate
nervous system to swell antidiuretic hormone secretion
§ Edematous states: heart failure, cirrhosis,
nephrotic syndrome
Expected Findings in Adults § Inadequate sodium intake (NPO status)
§ Physical assessment: vary with a normal, § Hyperglycemia
decreased, or increased ECF volume §
§ Vital signs: hypothermia, tachycardia,
rapid thready pulse, hypotension,
orthostatic hypotension
§ Neuromusculoskeletal: headache,
confusion, lethargy, muscle weakness Diagnosis Nursing Care
with possible respiratory compromise, § Monitor I&O and weigh the client daily
fatigue, decreased deep tendon Hyponatremia at the same time using the same scale
reflexes, seizures, coma (Na <136mEq/L) § Monitor vital signs & LOC
§ GI: increased motility, hyperactive § Follow any prescribed fluid restrictions
bowel sounds, abdominal cramping, § Monitor respiratory status if muscle
anorexia, nausea, vomiting weakness is present
§ Encourage floods and fluids high in
sodium (cheese, milk, condiments)
§ Fluid overload
Sodium o Restrict water intake as
§ Normal value: 136-145mEq/L prescribed
§ NA+ is the major electrolyte found in o This treatment is typically
ECF & is present in most body fluids & effective when fluid volume is
secretions normal to high
§ Regulation by ADH & Aldosterone § Severe hyponatremia
§ Regulates body fluids o Administer hypertonic oral and IV