Fluid and Electrolyte Imbalance: Hyponatremia
Hyponatremia
- Sodium is essential to maintain osmotic pressure and acid-base balance chemically and to transmit nerve impulses.
- Sodium levels are obtained through venous blood extraction.
- It is a metabolic disorder wherein the level of sodium in the blood is lower than normal (< 135 mEq/L).
- It is a result of one of the following:
- Severe burns
- Congestive heart failure
- Excessive fluid loss such as severe diarrhea, vomiting
- Excessive IV induction of nonelectrolyte fluids such as glucose
- Addison’s disease
- Severe nephritis
- Pyloric obstruction
- Malabsorption syndrome
- Diabetic acidosis
- Drugs such as diuretics
- Edema
- Large amounts of water per orem
- Hypothyroidism
- Excessive ADH production
Symptoms:
- altered mental status, restlessness
- convulsions
- fatigue, headache, irritability
- satiety
- muscle spasms or cramps
- muscle weakness
- nausea, vomiting
- restlessness
Treatment:
- Correct underlying disorder associated with hyponatremia.
- Intravenous fluid administration.
- Give sodium tablets.
- Water restriction.
- When exercising, keep hydrated.
Nursing Considerations:
- Strictly monitor fluid intake and output.
- Observe for dehydration. Accurately record state of hydration.
- Observe for neuromuscular changes such as declining levels of consciousness, fatigue and muscular weakness.
- Monitor for signs of edema and hypertension.
- Ensure adequate dietary sodium intake of 90 to 250 mEq/day.
Photo credits: www.health.howstuffworks.com
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
