simple ppt

1. JOHNY WILBERT, M.SC[N]
LECTURER,
APOLLO INSTITUTE OF HOSPITAL
MANAGEMENT AND ALLIED SCIENCE

2. Description
 Hyponatremia is a serum sodium level lower
than 135 mEq/L
Sodium imbalances usually are associated with
fluid volume imbalances.

3. Causes
1. Increased sodium excretion
a. Excessive diaphoresis
b. Diuretics
c. Vomiting
d. Diarrhea
e. Wound drainage, especially gastrointestinal
f. Renal disease
g. Decreased secretion of aldosterone
2. Inadequate sodium intake
a. Nothing by mouth
b. Low-salt diet

4. 3. Dilution of serum sodium
a. Excessive ingestion of hypotonic fluids or
irrigation with hypotonic fluids
b. Renal failure
c. Freshwater drowning
d. Syndrome of inappropriate antidiuretic
hormone secretion
e. Hyperglycemia
f. Congestive heart failure

5. Clinical manifestaion
Cardiovascular
Symptoms vary with changes in vascular volume
 Normovolemic: rapid pulse rate; normal blood
pressure
 Hypovolemic: thready, weak, rapid pulse rate;
hypotension;
flat neck veins; normal or low central venous
pressure
Hypervolemic: rapid, bounding pulse; blood
pressure normal or elevated; normal or elevated
central venous pressure

6. Neuromuscular
Generalized skeletal muscle weakness that is
worse in the extremities
 Diminished deep tendon reflexes
Central Nervous System
• Headache
• Personality changes
• Confusion
• Seizures
• Coma

7. Respiratory
Shallow, ineffective respiratory movement is a late
manifestation related to skeletal muscle weakness
Gastrointestinal
• Increased motility and hyperactive bowel sounds
• Nausea
• Abdominal cramping and diarrhea
Renal
• Increased urinary output
Integumentary
• Dry mucous membranes

8. Diagnostic evaluation
History collection
Physical examination
Serum sodium level less than 135 mEq/L
Decreased urinary specific gravity

9. Management
1. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and gastrointestinal
status.
2. If hyponatremia is accompanied by a fluid
volume deficit (hypovolemia), IV sodium
chloride infusions are administered to restore
sodium content and fluid volume.
3. If hyponatremia is accompanied by fluid
volume excess (hypervolemia), osmotic diuretics
are administered to promote the excretion
of water rather than sodium.

10. 4. If caused by inappropriate or excessive secretion
of antidiuretic hormone, medications that
antagonize
antidiuretic hormone may be administered.
5. Instruct the client to increase oral sodium intake
and inform the client about the foods to include
in the diet
6. If the client is taking lithium (Lithobid), monitor
the lithium level, because hyponatremia
can cause diminished lithium excretion, resulting
in toxicity.

11. Common Food
Sources
Bacon
Butter
Canned food
Cheese, such as
American or cottage
cheese
Frankfurtersmeat
Milk
Mustard
Processed food
Snack food
Soy sauce
Table salt
White and whole-
wheat
Bread
Ketchup

12. Thank you