Hyponatremia

Hyponatremia
Exercise–associated hyponatremia (EAH) is the most reasonable explanation of adverse changes in
athletes during the marathon events. Physiologically, EAH is defined as plasma– sodium
concentration that is below 135mmol/L. According to the decreasing plasma sodium level and
individual, there are diverse symptoms such as nausea, headache, lethargy and restlessness.
Although the sodium in sports drink could postpone the beginning of hyponatremia, drinking too
much could cause hyponatremia (Rosner and Kirven, 2007). That is, hyponatraemia is influenced by
both dilution of body sodium in body water overload and depletion of body sodium in body water
losses. A decreased plasma sodium concentration lead to an osmotic gradient between extracellular
and intracellular fluid in brain cells, causing water transfer into cells and increasing intracellular
volume (Rosner and Kirven, 2007). It triggers problem regarding tissue oedema, neurological and
low blood sodium concentration. ... Show more content on Helpwriting.net ...
The efferent renal sympathetic in the individuals' body are responding to the static contractions
during the marathon while muscles are freely perfused responds more vigorously to the static
contraction. Besides, the central command (mesencephalic locomotor region stimulation) and
endurance exercise pressor reflex raised the renal sympathetic nerve activity (Mitchell and Smith,
2008). The induced renal nerve increased in vascular resistance maintains the blood pressure in
metabolically induced vasodilation in the exercising muscles (Mitchell and Smith,
... Get more on HelpWriting.net ...

Hyponatremia Lab Report
Testing the effects of hyponatremia on apple skin cells
Written by: Jonathan Lee
Lab Partners: Caitlyn Johnson and Cole Vander Hoek.
Biology Period 6
Monday March, 29th 2016
Abstract: This experiment will be testing apple skin cell size with differentiating amounts of sodium
exposure. The experiment will be carried out by testing the skin of an apple with distilled water with
no sodium as our control and testing the apple skin with larger amounts of sodium. By doing this
experiment, it can build knowledge of hyponatremia, which is when a person's sodium level is
diluted by too much water. Past scientific studies show that a lesser amount of sodium will make the
cells larger, and more exposure to sodium will make them smaller. ... Show more content on
Helpwriting.net ...
The skin of the apple had little to no change when the salt water was introduced to the apple skin
cells.
Qualitative Results Continued: This second diagram shows the second time we did the trial with the
fresh water and the salt water. Again, not much change was seen when the apple skin was immersed
in the salt water.
Conclusion: In conclusion, the cell size had very little to no change when introduced to different
levels of sodium and distilled water. The apple skin was tested twice, being introduced to the same
amounts of distilled water and salt water. The cell size of the apple skin did not decrease much when
introduced to salt water as predicted. Additionally the cell size did not significantly increase when
introduced to pure water. Therefore, the hypothesis was inconclusive as there was change but very
little.
Questions:
In order to make the experiment better, the apple skin could have sat in the salt water solution for a
longer period of time to insure the salt water is actually getting into the apple skin. The amount of
trials also could have been increased to insure

Summary Of The Red Hat Hikers
Identify the disease process presented by the case study as well as the normal structure and function
of the organ system and/or physiological process. The patient in "The Red Hat Hikers" scenario is
suffering from hyponatremia. Hyponatremia is defined as a serum sodium level of less than
136mEq/L. Sodium is an electrolyte that is found predominately in the extracellular fluid, and it is
the chief regulator of water in the body. Sodium is also important for muscle contraction, nerve
impulses, acid–base balance and chemical reactions that occur inside the cell (McCance & Huether,
2014). Normal sodium levels in the body are maintained by the kidneys and the hormone
aldosterone. Aldosterone is secreted by the adrenal cortex at the completion of the renin–
angiotensin–aldosterone system, and it helps stimulate the proximal tubules of the kidneys to
reabsorb sodium and water. The anti–diuretic hormone (ADH) also indirectly affects sodium levels
because it regulates water balance in the body (McCance & Huether, 2014). ... Show more content
on Helpwriting.net ...
A basic or complete metabolic panel which shows the serum concentration of electrolytes is
sufficient to diagnose hyponatremia, however testing plasma osmolality and a urinalysis for sodium
level may be useful in determining the cause the hyponatremia if it is not apparent (Goh, 2004).
Treatments for hyponatremia are discussed in the section

Case Study 1 Essays
Ian Borchers
Bio201
Case Study #1
Lecture TTh 130–245p
Lab W 300–550p
Water Can Kill? Exploring Effects of Osmosis
Part I – Three True Stories
Questions
1. What sort of environment (hypertonic, isotonic, hypotonic) does consuming excessive amounts of
pure water create in the body fluid that surrounds your cells? What effect would this have on your
cells?
– A hypotonic environment would be created in the body fluid, as there would be a lower
concentration of solutes outside of the cell than inside the cell. This would create the effect of water
entering the cells at an abnormal rate, and the cells, eventually, would burst.
2. What types of symptoms did Jennifer, Cassandra, and James have in common? Which organ or
tissue seems to ... Show more content on Helpwriting.net ...
Part II – Facts about Hyponatremia
Questions
1. During periods of intense activity, your body releases an antidiuretic hormone called ADH or
vasopressin that causes the body to retain water (by decreasing the amount of water that is expelled
in urine). Why does this make endurance athletes particularly vulnerable to developing
hyponatremia?
– Endurance athletes are particularly vulnerable because over the extended period of time they are
not taking in salt, only water. This creates the hypotonic environment outside the cells because of
the salt concentration differential.
2. What might put desert–dwellers in danger of developing hyponatremia? How can they avoid this
danger?
– Desert dwellers could potentially continue drinking water without ingesting enough sodium to
keep the fluid around cells isotonic. Eating food with plenty of sodium or by adding salt to food so

as to retain water.
3. Babies and small children are at much greater risk for developing hyponatremia than adults. Why
is this?
– This is because they have less cells in general, and their bodies aren't able to take as much
damage.
4. Just how much brain swelling are we talking about? The volume of a human brain is normally
about 1,200cm3. The concentration of solutes in the cerebrospinal fluid (the fluid that surrounds the
brain and other parts of the central nervous system) is normally about 300mM.
a. Normally, what is the concentration of solutes

Post Chemotherapy Essay
Cancer is the one of those diseases which has high mortality rates in Pakistan. Most of these cases
are diagnosed in advanced stages. Chemotherapy is one of the treatment components of cancer
patients and electrolyte abnormalities are one of its common side effect. Electrolyte abnormalities
are frequent and complicating element of cancer, these abnormalities may be due to underlying
malignancy, a consequence of disease response or side effect of therapeutic agents, these side effects
can be hazardous and fatal in some cases. This review presents the electrolyte abnormalities that can
occur with the use of anticancer drugs. We have retrospectively reviewed the records of last 06
months of our admitted patients who were either admitted for longer regimes of chemotherapy or for
the management of post chemotherapy side effects. In this review we have included total 110
patients out of which Breast, lung and colorectal cancers are leading malignancies followed by ...
Show more content on Helpwriting.net ...
We found that, the patients who received Platinum–containing anticancer drugs they experience
mainly hypokalemia, hyponatremia and hypomagnesemia, the ones who received chemotherapy
with Alkylating agents have mainly developed hyponatremia, and those who received Vinca alkaloid
containing regimes are also associated with hyponatremia. Patient who received Epidermal growth
factor receptor monoclonal antibody inhibitors mainly experience hypomagnesemia, hypokalemia
and hypocalcemia. Other, monoclonal antibodies, such as Cetuximab, mainly cause hyponatremia.
All those patients who developed the drug related Tumor Lysis Syndrome their labs showed the
incidence of hyperphosphatemia, hyperkalemia and hypocalcemia. We also found the incidence of
hyponatremia and hypokalemia among those patients who received the chemotherapy with
relatively newer agents like Novolumab. Some other previous international publications are also
showed great similarity with our

##regulation Of Brain Derived Neurotrophic Factors In...
1.Specific Aims: Magnocellular neurosecretory cells (MNCs) located in the supraoptic (SON) and
paraventricular (PVN) nuclei of the hypothalamus synthesizes and regulates Arginine Vasopressin
(AVP) secretion (2, 6, 22, 24, 33, 36, 40, 46). Dysregulation of AVP release leads to dilutional
hyponatremia associated with liver and heart failure which increases morbidity and mortality (12,
23, 37, 51, 53, 65). The prevalence of hyponatremia despite treatment with AVP antagonist to
increase urine output, improve plasma sodium levels, and reduce ascites is prominent (5, 16, 52, 65).
During high salt loading and dehydration, MNCs has been shown to have upregulation of Brain
Derived Neurotrophic Factor (BDNF) (10, 13, 15, 32). BDNF has profound ... Show more content
Based on these findings, in conjunction with other previous studies, we have developed the
following working hypothesis (Figure 1).
Our working hypothesis is highly novel in that it focuses on BDNF from SON can contribute to
increased intracellular chloride, which in turn influence changes in AVP release and hyponatremia
during liver cirrhosis (Figure 1).
Our hypothesis will be addressed by the following specific aims:
1. To determine the role of BDNF–TrKB signaling in hyponatremia through sustained AVP release
during hepatic cirrhosis.
2. To understand the role of estrogen in preventing the chronic activation of vasopressin neurons in
female bile duct ligated rats.
These experiments will for the first time define the roles of BDNF–TrkB signaling in the hepatic
cirrhosis induced sustained AVP release along with sex differences in the regulation of AVP release.
An integrative approach will be employed that includes AAV shRNA knockdown in whole animal
experiments, molecular changes in RNA and protein expression, in vitro chloride imaging with
ClopHensorN and functional studies of fluid balance and circulating AVP in the rat. These studies
will address several critical gaps in the literature by determining the neural adaptations that
contribute to pathophysiology in an animal model of dilutional hyponatremia.
2. Background, Significance and Innovation: Dilutional hyponatremia is the most important
electrolyte abnormality

Nursing Care Plan Sample
Jonathan Czyzewski Soap #1 08/26/2017 Subjective: Chief Complaint (CC): Lightheadedness and
Dizziness History of Present Illness (HPI): Several Days of vomiting and diarrhea coupled with
inability to keep anything down. Past Medical History (PMH): Stated normal WT 136 lbs Social
History (SH): N/A Family History (FH): N/A Medication history: None Known Medication
Allergies: NKA Insurance Status: Unknown Review of Systems (ROS): N/A Objective: Vitals: 1. BP
(supine) 110/60 2. BP (standing) 95/45 3. HR 85 bmp 4. Ht 5'7" 5. Wt 133 lbs Labs: Chem 7 1. Na:
135 2. Cl:101 3. Bun: 30 4. K: 3.5 5. Bicarb: 6. Scr:1.1 7. Glucose: 105 8. Serum osmolality: 240
mosm/kg Physical Exam: not preformed Diagnostic: N/AAssessment: Appears to be hypotonic
hypovolemic hyponatremia secondary to several days of vomiting and diarrhea. ... Show more
content on Helpwriting.net ...
Guidelines from the American journal of medicine will be followed from Diagnosis, Evaluation, and
Treatment of Hyponatremia: Expert Panel Recommendations. Plan: 1. Pharmacologic a. Treat with
0.9% normal saline b. Toal fluid loss based on weigh is 136–133= 3lbs/ 2.2 = 1.36 L c. Replace ½
volume in 1st 8 hours and ½ in the next 16 hours d. 85ml/hour, for first 8 hours, then and 43 ml/
hour for next 16 hours e. Daily maintenance = 1500 ml + 20ml( IBW–20) = 1500 ml + 20 ml( 61.6–
20)= 2332 ml for 24 hours or 97ml per hour f. For first 8 hours run IV rate of 182 ml per hour, then
after that run IV rate of 140 ml per hour for final 16 hours. 2. Non–Pharmacologic a. Get patient to
keep food and water down 3. Monitoring a. Monitor patient intake of fluids if able to keep fluids
down, considering stopping IV fluids and allow patient to rehydrate orally b. Continue to monitor
vitals such as BP, HR to see if volume replacement is

Adrenal Crisis Of A Pediatric Patient : A Case Review Essay
Title Page
Adrenal crisis in a pediatric patient: A case review
400 W Mineral King Ave, Visalia, Ca 93291
Lake Erie College of Osteopathic Medicine, Kaweah Delta Health Care District
Adrenal crisis in a pediatric patient: A case review
1) Why is this topic important? It is important to rapidly identify adrenal crisis to correct the
underlying deficiency and treat the patient's symptoms to prevent further deterioration.
2) What does this study attempt to show? It attempts to highlight the importance of rapid correction
of cortisol to treat the underlying disorder of adrenal crisis and treat symptoms.
3) What are the key findings? This case of adrenal crisis was recognized by common signs and
symptoms of severe abdominal pain, nausea, vomiting, and fatigue. It was managed with fluids and
replacement of cortisol.
4) How is patient care impacted? If the signs and symptoms of adrenal crisis are recognized, patients
can be stabilized to prevent further deterioration. Additionally, management of chronic disease can
prevent continued decreases in function.
Abstract
Background
Addison's disease is a rare endocrine disorder caused by deficiency of cortisol that presents in a
chronic or acute course. Primary adrenal insufficiency is most often a result of autoimmune
destruction of the adrenal glands and can lead to an acute crisis. Common symptoms of addisonian
crisis are sudden abdominal pain, pain in legs, or lower back, nausea,

Hyponatremia Research Paper
Did you know that you can die from drinking too much water? Water intoxication can also be
referred to as "water poisoning." It can cause fatal disturbances in the brain functions. Meaning the
normal balance of electrolytes in the body is pushed outside safe limits by overhydration. If your
electrolytes drop too low too quickly, it can be fatal. Death by overhydration is rare, but it can still
happen. Drinking a large amount of water in a short period of time can be dangerous; it can cause a
level of salt, or sodium in your blood to drop too low. This is called "Hyponatremia," This is a very
serious condition that can be fatal. Some symptoms of Hyponatremia are nausea and vomiting,
muscle weakness, spasms or cramps, seizures, and loss of energy and fatigue. For serious
symptomatic hyponatremia, the first line of treatment is prompt intravenous infusion of hypertonic
saline. Untreated overhydration can lead to dangerously low levels of sodium in your blood. This
can cause more severe symptoms, such as muscle weakness, cramps, seizures and coma. You would
have to drink an enormous amount of water for this condition to happen. But ... Show more content
Not many people drink enough water in one day to get water intoxicated, but others are more at a
risk of not drinking enough. Even though the human body is about 60% water it would seem
unlikely to die from Hyponatremia, but in rare cases it still happens. Hyponatremia has become
more common for athletes with longer lasting activities like marathon runners or cycling. Where it's
easier for other sports activity to just take a quick water break. When you're thirsty it's a way of your
body telling you to hydrate, and how much you'll wanna drink. Drinking large amounts of water
won't cause overhydration, it's when your pituitary gland, kidneys, liver, and heart aren't
functionally working normally. Whereas an adults body's with a healthy kidney function can take in
six gallons of water on a regular daily

My Geriatric Assessment of Mr. Ta
Thank you very much for referring Mr. Ta for a geriatric assessment. The main concern is that of
recurrent hyponatremia.
He is an 86–year–old man who was born in Vietnam and came to Canada in 1995. He is married and
lives with his wife, 2 sons and daughter–in–law and 2 grandchildren in a townhouse. He has 3 sons
and 1 daughter. He speaks Cantonese. He has primary 3 education. He makes glass bottles.
One of his sons, Wayne is with him for the interview today. Mr. Ta complained about having
bilateral ankle sweating for a year. He has no orthopnea or paroxysmal nocturnal dyspnea. He uses
only one pillow to sleep. There is no shortness of breath on exertion. He does exercise regularly.
There are no recent falls. He had fallen about 2 years ago when he tripped on stairs. He sprained his
leg, but was fortunately without any fractures or serious injury. He was previously on propranolol,
but that has been changed to bisoprolol. He denied having any liver or renal problem.
He denied having any memory problem. He is safe at the stove and the tap.
He is independent in all aspects of basic ADLs. He bathes himself. For instrumental ADLs, he can
prepare his own meals. He does the cleaning and can make telephone calls. His family helps with
grocery shopping, laundry and financial management. He does not drive. He hand washes his
underwear.
He is an ex–smoker. He used to smoke less than a pack of cigarettes a day for over 40 years and
stopped smoking in the year 2000. He

Exercise Related Hyponatremia
How much water does it take to kill a person? According to new guidelines from an international
expert panel, if you are an athlete you should drink only when thirsty in order to avoid exercise–
associated hyponatremia (EAH) –– a form of water overdose. In the summer of 2014, two otherwise
healthy 17–year–old high–school football players died. In both cases, the common denominator was
excessive fluid consumption –– a peril that is often underestimated. What's exercise–related
hyponatremia? Water overdose occurs when a person drinks too much fluids and the kidneys cannot
"flush them out". This results in the excess water entering the cells and causing them to swell. That's
when something as vital as water can quickly turn lethal, according to the guidelines published in
the Clinical Journal of Sport Medicine. ... Show more content on Helpwriting.net ...
Cases have also been reported among people participating in "zen activities" such as lawn bowls and
yoga. At present, statistics show that at least 14 athletes are estimated to have died as a result of
EAH. Water overdose, intoxication is a real thing The American Chemistry Society says that it takes
about 6 liters of water to kill a 165–pound person. Death by water, or water intoxication as it's
officially known, is not a rare phenomenon. It's common among young people who challenge
themselves to "water drinking contests," or athletes who mistakenly over–hydrate while training,
Scientific American reported. To avoid water overdose, these new guidelines are targeting athletes in
particular. Experts say that administering a concentrated saline solution containing 3 percent sodium
–– about three times higher than the concentration in normal saline solution, is a life–saving
technique that can treat exercise–associated

How Is Salt Regulated In Our Body
Page 1 (Salt Regulation):
Why is salt important and how is salt regulated in our body?
Salt is important in our bodies because without it, our bodies become chemically unbalanced, our
muscles and nervous system stop working and, eventually, we die. So, salt is essential.
Salt is regulated in our body by the kidney and our adrenal gland. The adrenal gland produces a
hormone called aldosterone, which sends a message to the kidneys, saying how much sodium to
retain. Thus, salt regulation is part of the endocrine system.
Organs that help regulate salt in our body:
– Kidneys
– Adrenal gland
Which part of the brain controls homeostasis?
The hypothalamus controls homeostasis.
Why is the coordination of these homeostatic systems required to keep ... Show more content on
Helpwriting.net ...
It may result from excess fluid in the body relative to a normal amount of salt, or it could be a result
of loss of sodium and body fluid.
Cardiovascular disease:
Cardiovascular disease is a terminology referring to strokes, coronary heart disease and heart failure.
Salt is a major factor that increases the patient's blood pressure and is therefore responsible for many
heart attacks and strokes every year. Symptoms can include chest pain, shortness of breath, pain and
numbness in your legs and arms if the blood vessels in those parts of the body are narrowed (less
blood flowing through), pain in the neck, jaw, throat and upper abdomen or back.
Page 5 (Treatment of diseases):
Treatment of Hyponatremia:
Mild chronic hyponatremia may not need treatment other than adjustments to diet, lifestyle or
medications. For severe hyponatremia, treatment involves the intravenous administration of fluids
and electrolytes. Medication is also needed for the accompanying symptoms.
Treatment of Cardiovascular disease:

Changing your lifestyle, to help control and prevent the disease and heart attack, can treat
cardiovascular disease. It can also be treated by anti–platelet medicines such as aspirin, to keep
blood clots from

Exercise Associated Hyponatremia Essay
If you do not know by now Exercise–associated hyponatremia is a fluid–electrolyte disorder caused
by a decrease in sodium levels (hyponatremia) during or up to twenty–four hours after prolonged
physical activity. Exercise–associated hyponatremia (EAH) first was described in Durban, South
Africa, in 1981. If not taken care of immediately, EAH can led to tragic consequences. More than
500 marathons are held throughout the world each year, with the vast majority of competitors being
recreational athletes as larger marathons can have tens of thousands of participants. Six years ago I
remember a great friend of mine named Isaiah use to play football and ran marathons for Miramar
Senior High School. One day while I was home watching the news he was on television he had
collapsed on the field, but no one knew what caused this. So three weeks later after his autopsy it
was said due to over excessive amount of fluid it caused him to be put into a coma. Many athletes or
trainers do not realize what can happen to you if too much fluid is taken into the body. A study in
Boston showed 13% of the marathon runners in 2002 experienced EAH, most of the cases were
mild. I believe that most ... Show more content on Helpwriting.net ...
Exercise–associated hyponatremia can cause many problems such as signs and symptoms for the
world today. If you do not know by the very famous comedian named Kevin Hart has annual
marathons that he encourages his fans to get outside and run with him. This event is called Run with
hart. This is a good idea to help people become active and healthy but there is a downside many
people believe that it is a good idea to drink Gatorade or an energy drink to keep them hydrated. But
they are wrong instead this causes nausea which happens when the stomach feels some discomfort
in the upper stomach causing the urge to vomit. Marathons are not the only events that lead to
exercise associated

Malignant Mesothelioma Case Study
A 72–year–old former miner with metastatic pulmonary mesothelioma is brought to the emergency
department after his caregiver finds him unresponsive. The caregiver provides all of the history and
she states that over the past week, the man has been complaining of dyspnea, chest pain and has
become disoriented and delirious. Examination reveals a cachectic male exhibiting Cheyne–Stokes
respiration who does not respond to any commands. His temperature is 37°C (98.6°F), pulse is 60
beats/min, respirations are 23 breaths/min, and blood pressure is 140/70 mmHg. He responds to
painful stimuli in all four extremities. His pupils are equal in size, reactive, and light responsive.
Gag reflex is intact, along with corneal reflex. Mucous membranes and ... Show more content on
Helpwriting.net ...
This patient's kidney function is normal, which makes this diagnosis unlikely. Acute tubular necrosis
is diagnosed with a fractional excretion of sodium > 3% and presence of muddy casts in the
urinalysis.
Choice "B" is not the best answer. Ectopic ACTH secretion presents as a paraneoplastic syndrome in
patients with small–cell lung cancer, pancreatic carcinoma, neural tumors and thymomas. Elevated
ACTH levels present with hyperglycemia, cushingoid features, acanthosis nigricans, cutaneous tags
in the axilla, osteoporosis, polyuria, and hypertension.
Choice "D" is not the best answer. While parathyroid hormone–related protein (PTHrP) is secreted
by mesotheliomas rarely, this patient has a normal calcium level, which excludes this diagnosis.
Other cancers that secrete PTHrP include breast cancer, squamous–cell lung cancer, squamous
carcinoma of the head and neck, renal cell carcinoma, and bladder cancer to name a few.
Choice "E" is not the best answer. Primary hyperaldosteronism presents with hypertension,
hypokalemia, high serum aldosterone, low serum rennin and alkalosis. It is found in patients with
adrenal adenomas, idiopathic adrenal hyperplasia, and rarely adrenal

Hyponatremia Case Study
Administration inappropriate hypotonic intravenous fluid after surgery.
Sever malnutrition, in diet that depend on high water intake and low protein. This will limit the
ability of the kidney to handle the free water when there is decrease intake of solutes.
The compulsive intake of large amount of water will exceed the dilute capacity of the kidney which
is >20 L/d even if its with normal solute intake which is 600–900 mOsm/d.
NSAID may increase the risk of developing hyponatremia by inhibiting prostaglandin formation.
Prostaglandin reduction will increase NaCl reabsorption in the thick ascending Henle and ADH
action in the collecting duct which lead to impairment in free water excretion. [1]
Excessive fluid losses for example vomiting ... Show more content on Helpwriting.net ...
sodium is the most abundant electrolyte on the extra cellular fluid, and is a good indicator of water
body balance. Water always follow sodium.
2. The kidneys are responsible for execrating sodium from the body.
Hyponatremia occur when there is drop on serum level which is calculated as 2(Na) mEq/L + serum
glucose (mg/dL)/18 + BUN (mg/dL)/2.8. although its occur only when there is impairment on free
water excretion. [3]
Hypoosmolality (serum osmolality < 280 mOsm/kg) indicate excess in total body water relative to
the solute in the ECF as the water moves freely between Intracellular compartment and extracellular
compartment. This will cause imbalance which can due to solute depletion and solute dilution.
solute depletion: sodium loss corresponding to fluid loss. We see it in case of hypovolemia and it
will cause decrease blood pressure, weight loss, tachy pulse, dry skin, and low urine specific gravity.
solute dilution: low sodium level due to excessive water. We see it in case of hypervolemia and it
will cause high blood pressure, weight gain, rapid pulse and high urine specific gravity. [4]
When there is acute drop in serum osmolality, neuronal cell will swell because of water shifting
from extracellular compartment to intracellular compartment.

Evaluation of Impact of Desmopressin and Alpha1 Blocker...
We evaluated the impact of desmopressin and α1–blocker tamsulosin combined therapy in treatment
of LUTS/BPH patients with noctuia. BPH is a common disorder, which affect about 40% of men
older than 50 years. Nocturia is a common manifestation of BPH (6) that is not only bothersome but
can also have a marked impact on sleep patterns and decreases the QoL (9, 10). Different treatment
modalities for LUTS/BPH have been used with success. However, treatment for nocturia has been
reported to be less satisfactory than treatment of other LUTS and remains one of the most difficult
LUTs to treat. Different treatment plans were assessed, either for nocturia by itself or that occurring
in association with BPH. As, BPH is a potential risk factor for nocturia, α blockers are considered a
potential treatment for nocturia (11). The α1–blockers are the most common treatment for
LUTS/BPH and all currently available α1–blockers have similar efficacy and improve symptoms by
approximately 35% and Qmax by 1.8–2.5 mL/s (12, 13). Many studies assessed the effect of α1–
blockers, either alone or in combination with 5–α reductase inhibitors on nocturia associated with
BPH. Tamsulosin OCAS 0.4 was evaluated in BPH patients with ≥ 2 night voids and was proved to
significantly improve the mean IPSS when compared to placebo (14). However, the reduction in
nocturnal voids was associated with a minimal difference between tamsulosin and placebo with a
mean change of 3.1 to 2.0 night voids for tamsulosin and

Hyponatremia Research Paper
Hyponatremia
Hyponatremia is a common electrolyte imbalance seen by medical professionals. The cause is a
disruption of sodium water homeostasis usually maintained by "complex multi–system
physiological mechanism" explained Soiza et al (2014).
In hyponatremia the serum sodium concentration is below 135 meq/l. This condition is frequently
seen in older patients due to degenerate physiology, multiple co–morbidities and polypharmacy
discussed Soiza et al (2014).
Symptoms of hyponatremia include nausea, vomiting, headaches, changes in cognition, restlessness,
irritability, muscle weakness or spasms, drowsiness, seizures and coma.
Particular causes of hyponatremia include fluids loss due to vomiting, diarrhea or diuretic therapy,
low protein ... Show more content on Helpwriting.net ...
Hyponatremia can develop in patients treated with thiazide type diuretics after many months of
treatment. Elderly patients with low body mass and a reduce ability to excrete water load have a
higher chance of developing thiazide induce hyponatremia Factors like gastrointestinal or
respiratory illness, increases of diuretic dosage or the development of heart failure can also increase
the risk of hyponatremia in patients receiving treatment with thiazide diuretics reported Sterns
(2014).
Symptoms
The major clinical manifestation of hyponatremia includes nausea and malaise when serum sodium
concentration falls below 125– 130meq/L. Other symptoms associated with thiazide induce
hyponatremia include malaise, lethargy, dizzy spells and vomiting which are symptoms experienced
with severe hyponatremia. In thiazide induce hyponatremia there is weight gain, blood urea nitrogen
and plasma creatinine levels are usually low to normal and hypouricemia may be present explained

emazariegos case study 04 030115 Essay
Module 08 Case Study: Urinary System and Electrolyte/Acid–Base/pH Balance
Each question is worth 1 point, unless otherwise noted.
I Got To Micturate: Part I–"Mini Case Studies" Questions
Case 1: Frank Johnson
1. How does the urinary system relate to sexual function in males? How does the prostate relate to
the bladder infections in males?
The reproductive system in the male is closely intertwined with the urinary system, both
functionally and anatomically. The male reproductive system is so closely linked with the urinary
tract, that urinary health is important for optimum sexual health in the male. When the prostrate is
enlarged it can cause a urinary bladder infection in males.
2. On Frank's follow up examination, what are some ... Show more content on Helpwriting.net ...
If so, how?
The initial symptoms are urine incontinence, difficult urination, and a strong urge to pee but very
little being released. Yes these symptoms can be caused from pregnancy because hormonal changes
can cause blood to flow more quickly through the kidneys causing the bladder to fill much quicker.
13. What does Debbie's test results indicate?
Because of the positive nitrite and small amount of leukocytes I would say that could indicate a
urinary tract infection.
14. What symptoms were concerning that Debbie developed after her initial doctor's visit?
Debbie's fever, the chills and the nausea are all very concerning symptoms. |
15. What do these new symptoms possible indicate with Debbie?
The lower back pain could indicate a possible kidney infection, which is why I believe the doctor,
told her to rush to the hospital.
16. Why could this be a possible medical emergency for Debbie?
A kidney infection if not treated quickly and properly can permanently damage your kidneys or the
bacteria can spread to your bloodstream and cause a life–threatening infection.
17. How is this condition treated during pregnancy?

Although it is preferred that pregnant women do not take medications because of the affects it could
have on the baby, there are a number of antibiotics that are effective in treating kidney and urinary
tract infections that are known to be safe for both mother and baby. Such antibiotics are cephalexin,
ampicillin, and

Hyponatremia Case Studies
The patient is a 57–year–old female who was electively admission for an orthopedic procedure. She
has a very complicated past medical history including multiple medical problems hypertension,
dyslipidemia, bowel syndrome with severe constipation, anorexia nervosa, depression, history of
compulsive water drinking to the point of developing hyponatremia and she also has a neurogenic
bladder which requires self–catheterization up to 5 times a day. She has also history of anemia of
chronic disease and severe osteoporosis. She has compression fractures of the dorsal spine, first of
the left elbow, as well as a fracture of her right hip and she suffers from great deal of pain in her
right arm and wrist for a number of years. The patient underwent

The Importance of Potassium for the Human Body
Potassium is a mineral that is needed for the body to function properly. It was first discovered in
1807 by Humphry Davy. It is important for both cellular and electrical function. Potassium is an
important electrolyte in the human body. It helps control the amount of water in the human body,
and help maintain a healthy pH level. Electrolytes are lost through sweat, so it is important always
have a source potassium during or after physical activity. Potassium is also important for the balance
of blood pressure. It helps lower your blood pressure, along with sodium. Even though potassium
helps lower your blood pressure, there are other things that affect it.
Potassium is really important in for the ability for your skeletal and smooth muscles to contract. It
also vital for the health of your heart. Without potassium the heart have irregular heart beats which
could be life threatening. That is why people should always maintain an adequate amount of
potassium. The Institute of Medicine recommends adults get 4,700 milligrams of potassium per day,
while breast–feeding women should increase their potassium intake to 5,100 milligrams per day.
The human body excretes excess potassium, so there is no threat of taking too much. However if
you don't absorb enough potassium you could develop irregular heart beats, and possible the
cirrhosis of the liver. Potassium is found in many foods, but vegetables will give you the highest
source of potassium. Potatoes have the highest amount

Fluid And Electrolyte Shifts During Health Adult Marathon...
Fluid & Electrolyte Shifts in Health Adult Marathon Runner
It is evident that healthy adults running a marathon that replaces with only free water will run into
pathophysiology challenges that will affect performance. Adequate fluid intake is crucial for
prolonged, strenuous exercises to maintain adequate hydration, thermoregulation, maintain plasma
volume and avoid dehydration (Duvillard et al, 2004). Although athletes are prone to hydrate as
much as they can during extensive marathons, research shows that fluid replacement with only free
water or even hypotonic beverages can be detrimental.
Marathon runners put their body through great physical challenges, but in order to prevent
physiologic harm, the normal fluid and electrolyte status of an adult marathon runner is important to
know. For a normal adult male, the total body water (TBW) in relation to body weight is about 60%,
and in females, the percentage is 50 (McCance, 2010). About two thirds of the TBW resides in the
intracellular fluid (ICF), in other words blood, and the rest of the TBW remains in the extracellular
fluid (ECF), interstitial and intravascular (McCance, 2010). Depending on the age, sex, percent of
body fat and exercise status, the TBW will vary among individuals, which is very important in
considering the manifestations of fluid replacement in marathon running (Duvillard et al, 2004).
Electrolyte balance is also a crucial aspect in maintaining homeostasis in the body. According to
McCance, the

Arginine Vasopressin
ANTIDIURETIC HORMONE [3,18] Arginine vasopressin(AVP) formerly known as anti diuretic
hormone is an endogenous hormone synthesized in the cell bodies of magnocellular neurons located
in the supraoptic & paraventricular nucleus in hypothalamus, secreted in response to osmotic & non
osmotic stimuli and regulated by cell volume of osmoreceptor cells located near supraoptic nuclei in
anterior hypothalamus.
It is responsible for maintaining plasma volume and osmolality.
The picture below shows the vasopressin release in correspondence to serum osmolality and as well
the thirst response.
Fig 6: Relation between vasopressin levels, serum osmolality, urine osmolality and thirst mechanism
AVP binds to three receptors V1 (a&b), V2 and V3. ... Show more content on Helpwriting.net ...
Onset of action is 2–4hours after administration & peak effects reaches in 4–8 hours. Food does not
appear to affect the drug's bioavailability, onset of action or duration of effect.
Plasma protein binding: 99%.
Half–life: 12hours.
Volume of distribution: 3L/Kg; increased in the patients with hepatic impairment but effect of renal
impairment is not known.
Metabolism: In the liver by CYP 3A4 into inactive metabolites.
Excretion: By the liver and hence clearance is decreased in the patients with moderate to severe
hepatic impairment but renal impairment does not affect the clearance.
INDICATIONS
Tolvaptan was approved for use in the U.S. in May 2009 for patients with hypervolemic and
euvolemic hyponatremia, including those with HF, cirrhosis, and SIADH with serum sodium level
of less than 125 mEq/L. It can also be used if the patients with a serum sodium level of 125 to 134
mEq/L if they have symptoms and have not responded to fluid restriction.
DOSAGE
Adult dose is 15 mg orally once daily to a maximum of 60 mg daily.
Fluid restriction should not be done for the first 24 hours of starting tolvaptan to avoid rapid
correction of the sodium

Hyponatremia Case Study
Choice "E" is the best answer. The treatment of SIADH and the need for rapid correction of
hyponatremia depend on the degree of hyponatremia, whether the patient is symptomatic, and on
whether the hyponatremia is acute (< 48 h) or chronic. The patient is experiencing severe symptoms
of hyponatremia (unresponsive, Cheyne–Stokes respirations). Usage of any or a combination of the
following is indicated: 3% hypertonic saline, loop diuretic with saline, vasopressin–2 receptor
antagonists (vaptans), and water restriction. Furosemide and other loop diuretics can be used to
increase the excretion of free water. The amount of excess water that must be removed to correct the
hyponatremia can be calculated using total body water (TBW). TBW equals body

Addison's Disease Case Study
Addison's disease is a disorder commonly caused by an autoimmune reaction. It refers to a
deficiency of adrenocortical secretions, glucocorticoids, mineralocorticoids and androgens. The
major effects of these hormonal deficits include decreased blood glucose levels, poor stress
response, fatigues, weight loss, and frequent infections. (VanMeter & Hubert, 2014) This case study
examines the signs and symptoms of a forty–two–year–old Native American woman, newly
diagnosed with Addison's disease as well as treatment and most appropriate nursing interventions.
Problem Identification and Underlining Pathophysiology
Ms. Beth Thomas has stated that she was told she has Addison's disease prior to this emergency
room visit. This patient ... Show more content on Helpwriting.net ...
The following are current problems patient is experiencing with active nursing interventions.
1. Hyponatremia, hyperkalemia, and elevated blood urea nitrogen, low cortisol levels– monitor lab
results, and report abnormal levels to MD. Assess patient for confusion, seizure activity, nausea,
vomiting, and diarrhea, etc. Encourage sodium intake with meals, monitor water intake, but
encourage fluids. Strict intake and output. Administer IV fluids as ordered, as well as medications to
assist in lowering potassium and raising sodium, and raising cortisol levels. Assessment of heart
sounds and strength of pulse, as well as any complaints from patient of heart palpitations.
2. Hypoglycemia– frequent monitoring of blood glucose levels, monitoring for symptoms of
hypoglycemia, such as, but not limited to anxiety, feeling shaky or nervous, having chills, feeling
sweaty, but skin is cool and clammy. Also becoming confused, with an increased heart rate, and
being light headed or dizzy. ("Diabetes Forecast," 2013) Intervention as needed to increase blood

Multiple Myeloma Case
A 71–year–old male with known multiple myeloma presents to his physician's office complaining of
progressive back pain and increasing fatigue. He has had no diarrhea or vomiting. The patient was
diagnosed with multiple myeloma 3 years ago, at which time he was not considered a good
candidate for bone marrow transplantation. He was started on chemotherapy with melphalan and
prednisone with bortezomib (a proteasome inhibitor) and thalidomide for maintenance.
Bisphosphates were given to control bone pathology. The disease has progressed significantly over
the past year, with his M–spike increasing fourfold to 12 gm/dL.
Physical examination reveals dull lower back pain to percussion. Lung auscultation is clear, no S3
heart sound is heard, and ... Show more content on Helpwriting.net ...
True hyponatremia has a decreased serum osmolality. Osmolality is a colligative property of
solutions that depends only on the number of solute particles present in a given volume of solution.
The three types of solutes most often encountered in biological fluids are electrolytes, organic
molecules, and colloids. Sodium and its counter ions (e.g., chloride [Cl–]) are the major contributors
to serum osmolality. The other two principal active osmolar solutes in serum are urea and glucose.
The reference interval for serum osmolality in healthy individuals is typically 282–300 mOsm/kg of
water (H2O). The most commonly used formula for estimating serum osmolality

How To Write A Hyponatremia Case Study
Clinical case A 34–year–old previously healthy woman, transferred from another hospital presents
for neck stiffness, lethargy and abnormal jerks of all four limbs. Three months ago, she had severe
weight loss (around 20 kilos) and she complained of subacute headache, without cranial nerve
involvement, associated to ow grade fever and vomiting on day of admission. Because of sudden
alter level of consciousness and with hyponatremia (130 mEq/l) and slightly elevation in Lactate
dehydrogenase (LDH equal 233 U/L), seen on biological findings and decline in her general state
especially neurological progress she was transferred to Intensive care unit for further management.
Intervention: radiological findings The cerebral MRI shows: – Communicating ... Show more
content on Helpwriting.net ...
Treatment /Results The antitubercular quadri–therapy was initiated on the day of admission. In order
to improve neurological progress steroids, and valproic acid were added. Plus, PCR MTB taken
from the LCR(shunt) few days upon arrival was positive. But, the patient didn't respond to valproic
acid treatment and after sedation was stopped and the neurological examination showed
decerebration on the left and decortication of the right with unilateral right mydriasis with absent
oculo–cephalic reflex and preserved corneal reflex. During her course in the hospital, the patient had
fever on and off with clinical deterioration; she left the hospital after 3 month of hospitalization, on
Isoniazid and Rifampin p.o treatment for 9 months. Six month later she died. Background After
reaching a primary focus, Mycobacterium tuberculosis causes bacteremia and spread to meninges
and brain parenchyma, to rupture then into subarachnoid space. This rupture leaves many sequelae
among which cerebral tuberculous vasculitis is a really dramatic one. The following diagram
highlights these

Analysis Of The Article 'Intoxicated By Water'
"Intoxicated by Water" In the September 1st Science Times, an article titled "Intoxicated by Water"
was published. The article discussed the findings of Dr. Kevin Miller, an associate professor at
Central Michigan University, concerning hyponatremia, a condition the body experiences if too
much fluid is consumed in a short amount of time. This condition is also referred to as water
intoxication. Water intoxication is very serious and, in some cases, can even be fatal. Dr. Miller's
research addressed the problem of telling athletes too drink before, during, and after workouts,
whether or not they are thirsty. He found that athletes who abided by this rule could drink gallons
upon gallons of fluids that their body did not need. The large amount of excess water if not lost by
sweating or urination, instead entered the bloodstream. This decreased the ... Show more content on
Helpwriting.net ...
Hypotonic conditions cause cells to lyse and burst. "Older Runners, Shorter Strides" In the
September 15th issue of Science Times, an article was published titled "Older Runners, Shorter
Strides." This article explained a study done by Dr. Paul DeVita concerning slower running speeds
found in older people. Many observations revealed that running speeds seem to decrease with age.
For example, the marathon record time for a man around age 30 is over an hour less than that for a
man in his 80s. Dr. DeVita sought to find why this occurs. He and his partner studied 110 runners
and measured the force of their feet striking the ground, stride length, and speed. The experiment
showed that older runners tend to use fewer muscles in their lower legs than younger runners. Next
Dr. DeVita explored possible reasons why older runners do not use the same muscles. One possible
explanation is that the muscles in the lower leg are prone to injury and early aging. To combat this,
runners could strengthen their calf and ankle

Slow Hyponatremia Correction
Central Pontine Myelinolysis in the setting of Slow Hyponatremia Correction
Wu, Alex M.D.1, Harvin, Lisa D.O., M.S.2, Chen, Hsiong M.D.3
1. Resident – Department of Medicine, Franklin Square Medical Center, MD
2. Resident – Department of Medicine, Franklin Square Medical Center, MD
3. Neurology Hospitalist – Department of Neurology, Franklin Square Medical Center, MD
Introduction
Central Pontine Myelinolysis is often a feared complication of overly aggressive correction of
hyponatremia. As a result, close monitoring and slow correction are desired in order to prevent such
neurological outcome. We describe a case in which an elderly gentleman, with a past medical
history of CML and Polio, who was admitted to our hospital for generalized ... Show more content
CT of the Head Fig 2. MRI of the Brain, T2–Weighted FLAIR Fig 3. MRI of the Brain, T2–
Weighted FLAIR Fig 4. MRI of the Brain, T2–Weighted FLAIR Fig 5. Trend of Serum Sodium
Fluids Given by Day Daily Max Serum Sodium (mmol/L)
Day 1 Started at 1428
Normal saline 2 L 75 mL/h Started at 2225
Normal saline 2 L 75 mL/h 120
Day 2 127
Normal saline 0.5 L bolus 123
Day 4 124
Day 5 124
Normal saline 1 L 100 mL/h Started 1300
D5W + NaHCO3 1 L 200 mL/h 138
Day 9 140
Normal saline 1 L 100 mL/h Started at 1907
Lactated ringers 1 L 100 mL/h 140
Lactated ringers 1 L 100 mL/h 143

Day 12 148
Day 13 152
Day 14 154
Table 1. IV Fluids

Factors Affecting The Human Body
In order for the Human Body to maintain balance within its internal environment or return systems
to functioning within a normal range, it must manage a multitude of highly complex interactions in
order to deal with external changes that are optimal for survival. The organs that help maintain
homeostasis are the liver, the kidneys, and the brain through hypothalamus, the autonomic nervous
system and the endocrine system. The main function of the liver is to metabolize toxic substance as
well as stabilising carbohydrate metabolism. The kidneys are responsible for a number of things.
They regulate blood water levels, re–absorb substances into the blood, maintain salt and ion levels
in the blood, regulate blood pH, and excrete urea and other wastes, however, there are many factors
that can disrupt this process resulting in homeostatic imbalance which may cause disease or death.
Factors that need to be carefully controlled are body temperature, water content, carbon dioxide
level, and blood sugar level. It is crucial to ensure that these factors are maintained throughout
homeostasis. A major factor that affects homeostasis, in general, is water and salt balance.
Most people believe it is vital to stay hydrated during strenuous amounts of exercises however this
is not necessarily the case for those embarking on the Kokoda track. Water plays a critical role in
homeostasis. The amount of water in the body should be kept balanced all the time in order to
prevent cells from being

Description And Description Of The Diagnosis
2. Description of the Diagnosis:
Hyponatremia is the consequence of a pathological change in intake and output and reflects an
exacerbation of the free water substance to solute degree and is connected to tonicity. Hyponatremia
is oftentimes accompanied by other medical conditions such as dehydration or hypovolemia.
Contemplations of hidden pathologies help the health awareness group in distinguishing the
complete etiological picture, alongside the treatment arrangement (Treas & Wilkinson, p. 1384).
There are various components involved in the management of electrolyte equalization. An
arrangement of complex connections between cardiovascular, renal, endocrine, cerebrum,
pneumonic, and vasculature structures. Despite the fact that Hyponatremia can start from a variety
of predecessors, instances of fluid and electrolyte irregularity 's incorporate essential periphery
vasculature forerunners. The key structures included in a circumstance of hyponatremia incorporate
vessels, channels, interstitial fluid, and additionally the cells cytoplasm (Al–Salman, Kemp, Randall,
2002 ).
Fluids within our bodies are fundamentally made out of water but also containing particles and
diverse solutes that rule osmotic parity. Body fluids can be placed into two noteworthy divisions–
intracellular fluids and extracellular fluids. Intracellular fluids are substances contained inside of the
cell, additionally alluded to as the cytoplasm. Extracellular fluid is found outside of the cells

Antidiuretic Hormone Secretion: A Case Study
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is defined by hyponatremia
(low plasma sodium ion concentrations) due to continued renal excretion of sodium in the face of its
dilution in the plasma due to water retention (i.e dilution of sodium ions). This occurs due to the
hypo–osmolality resulting from the inappropriate, continued secretion and action of the antidiuretic
hormone arginine vasopressin (AVP) despite normal or increased plasma volume. This hormone is
transported intra–axonally from the site of its synthesis in the hypothalamus to the synaptic
termination of the axons of the hypothalamic neurons in the posterior pituitary gland. This results in
impaired water excretion. Conditions that dysregulate ADH secretion in the central nervous system
include tumors that secrete ADH and drugs that increase ADH secretion. Heart failure can also cause
increased ADH production. Heart failure would decrease cardiac output and lower blood pressure.
This would activate the RAAS pathway whereby angiotensin produced by the liver would be
converted to angiotensin 1 by rennin (produced by juxtaglomerular apparatus in the kidney), and
ACE (an enzyme produced by the lungs) would cobnvert it to angiotensin 2. Angiotensin 2 would
then act on the posterior ... Show more content on Helpwriting.net ...
Symptoms, in more severe cases of SIADH, may include: nausea/vomiting; cramps/ tremors;
depressed mood, memory impairment/irritability. Personality changes include combativeness,
confusion, and hallucinations. Other changes include, seizures, stupor or coma. This is a predictable
list of responses to increased water retention, as water retention results in a hypotonic environment
for cells. In hypotonic environments, water moves into cells causing swelling and eventually cell
lysis. Swelling of cells, especially in the brain, can cause edema, which is characterized by the
neurological changes described above, including confusion, nausea and

Superior Vena Cava Syndrome
Human life starts from a fertilized cell which breaks down, again and again, an adult human body is
composed of the abundance of cells and each one have their own specific function to perform.
During adulthood, most of the cell does not duplicate except some cells continue to divide to replace
the old or damaged cell in blood, skin and intestine. This growth is very controlled and no excessive
cell growth takes place. But sometimes when a mutation occurs in one or more genes which causes
unnecessary cell reproduction and as a conclusion, there is no control over the growth of cells. It is
called malignant transformation and this is the starting of cancer (Hosick et al., 2015). There are
many different types of cancer but the early stage diagnosis ... Show more content on
Helpwriting.net ...
They go through enormous physiological and psychological stressors once they diagnosed and
throughout their treatment program. There is an immediate need of rehabilitation program for cancer
patients to meet their physiological and psychological need. Those who try to manage their stress
with risky behaviors such as smoking and drinking or they live sedentary lives can lead to poor
quality of life during their diagnosis and their treatment (Harding, M. 2012). On the other hand
people with the good coping mechanism, they deal their stressors with effective relaxation technique
and have less psychological and physiological stress related to cancer and its treatment. Evidence
from experimental studies shows that psychological stress increases the tumor to grow and advance
quickly. As a nurse, we should provide emotional and social support that can help patient to cope
effectively with their psychological stressors (Andrykowski et al., 2008). This will help them reduce
anxiety and also assist them in adopting good coping behavior for example participation in yoga and
meditation. Other approaches of good coping behaviors are exercise, participating in counseling and
attending cancer education programs (NCI, 2015). Also, people who used to exercise before their
cancer diagnosis they cannot return to their same level of physical activity due to fatigue and pain.
As

Hyponatremia Nursing Care Plan
Nursing Diagnosis The patient presents with urinary tract infection (UTI), hyponatremia, severe
dehydration, cerebrovascular accident in October, dysphagia, leucocytosis with hemiparesis.
Nursing diagnoses for these are mentioned below individually (Doenges, Moorhouse and Murr,
2010): Urinary tract infection: risk for acute pain, risk for fluid volume deficit and impaired urinary
elimination. Hyponatremia: Risk for electrolyte imbalance Severe dehydration: Fluid volume deficit.
Dysphagia: Impaired swallowing and imbalanced nutrition. Nursing Care Plan for Hyponatremia:
The nursing care of a patient with hyponatremia should consists of health promotion, assessment,
nursing diagnosis, interventions and community based–care. (LeMone,

Inappropriate Hyponatremia Essay
EUVOLEMIC HYPONATREMIA: MECHANISM SYNDROME OF INAPPROPRIATE
ANTIDIURETIC HORMONE SECRETION [5,13] SIADH is the most common cause of
hyponatremia [13]. It is caused by inappropriate vasopressin secretion either from the pituitary or
from the ectopic source independent of the circulatory volume status and serum osmolality resulting
in hyponatremia. Also there occurs inappropriate diuresis due to the action of vasopressin in the
collecting tubules and its action continues until V2 receptors are down regulated (vasopressin
escape) [5]. There are multiple etiological factors as mentioned earlier cause inappropriate ADH
secretion. A Schwartz criterion is used for diagnosing SIADH which is mentioned below: Diagnostic
Criteria for SIADH:Schwartz diagnostic criteria [5,13] ESSENTIAL CRITERIA  Decreasing
measured serum ... Show more content on Helpwriting.net ...
ACEI causes hyponatremia by blocking the conversion of angiotensin I to angiotensin II in the
peripheral circulation but not in the brain where angiotensin I gets converted to angiotensin II [16].
Angiotensin II is known to stimulate the release of ADH resulting in hyponatremia [18].
Angiotensin II type I receptor blocker causes hyponatremia by blocking the effects of aldosterone
resulting in hyponatremia when combined with thiazides causes severe hyponatremia [17 ] .
APPROACH TO A PATIENT WITH HYPONATREMIA [5,19]  Assess for the severity of
symptoms  Duration of the symptoms  Check for the volume status  Assess for the causes of
hyponatremia such as drug history  Do the necessary investigations such as serum & urine
osmolality, urine spot sodium, thyroid function test and serum cortisol levels. PRINCIPLES OF
SODIUM CORRECTION The treatment of hyponatremia depends upon  Severity of symptoms 
Duration of hyponatremia(acute or chronic)  Cause of

Hyponatremia Lab Report
Use safety precautions to prevent injury or death when administering parental potassium–containing
solutions. Before giving patient IV potassium (KCl), the nurse must have an order, review the
patient's medical history, reviewed the lab values, educated the patient on the reason for the
transfusion and inform the patient on their right to refuse. After the nurse gets the order for KCl, she
must check and re–check the dilution of the drug in the IV solution container. The dilution should
not be greater than 1mEq of potassium to 10mL of solution. Potassium must be diluted because it
can cause phlebitis and loss of function to the vein. In extreme cases, the patient may need
reconstructive surgery. The nurse should not infuse KCl over 20mEq/hr. ... Show more content on
Helpwriting.net ...
For example, when a person is hyperventilating, the respiratory system responds immediately to
change in the patient's acid–base status. The patient's depth and respiratory rate will increase in
efforts to lose excess carbon dioxide. Once the ECF levels of carbon dioxide and the free hydrogen
decrease, the lungs can fully compensate, and the PH will return to reference range. Kidney
compensation is an attempt by the kidneys to regulate the overall level of acidity, or pH, of blood.
The renal system will kick in if the respiratory system is not enough to correct the problem. It can
take several days for the renal compensation to kick in and stabilize the pH. If the kidneys cannot
maintain the desired value if the underlying cause of the problem is not addressed. The kidney can
absorb more acids, bases or bicarbonate as needed to keep the body at homeostasis (Ignatavicius,
2013, p.

The Rights Of The United States
It has been a long time since the question whether America should set English as its official
language became controversial. Majority of people in this country consciously accept the fact that
English is most directly relevant to their success, however, English–only policy is actually violating
the spirit of America and may result in serious problems in some cases. Enforcement of English–
only policy can be considered as a behavior that runs counter to the purpose of this country. "The
liberties of our country, the freedom of our civil constitution, are worth defending against all
hazards: And it is our duty to defend them against all attacks," what Samuel Adams said profoundly
echoes to the constitution wrote by the ... Show more content on Helpwriting.net ...
English–only policy in the workplace tends to cause a hostile working environment and makes
employees feel as they have done something wrong for speaking their native language. Many
employees feel that they are automatically being distributed into a lower social status and will not be
admitted by their colleagues as Americans until they abandon their own language and speak English
only. Feeling discriminated against many employees have filed lawsuits with the EEOC in order to
stop such inequity. Last year, GREEN BAY, Wis. –Wisconsin Plastics, Inc. (WPI), a metal and
plastic products manufacturer based in Green Bay was sued by EEOC in order that they defeated
Title VII of the Civil Rights of 1964, which protects employees from discrimination based on
national origin, which includes the linguistic characteristics of a national origin group, by firing a
group of Hmong and Hispanic employees because of their national origin. To this case, EEOC
Chicago Regional Attorney John C. Hendrickson has expressed his feeling: "Our experience at the
EEOC has been that so–called "English only" rules and requirements of English fluency are often
employed to make what is really discrimination appear acceptable. But superficial appearances are

Crystalloids
Crystalloids are a type of fluid and electrolytes therapy. They are water and salt solution that is made
up of small molecules that may be dextrose or non–dextrose. The small molecules make it easier for
its solution to transfer from the blood into the cells and body tissue and may increase the fluid
volume in both interstitial and intravascular spaces. A crystalloids solution can be hypotonic,
hypertonic or isotonic. Hypotonic solutions are a diluted solution made up of mostly water with very
little particles. They are used to treat patient with conditions such as diabetic ketoacidosis, and
hyperosmolar hyperglycemic state that leads to intracellular dehydration. Once it enters into the
body it works by the process of osmosis causing water to leave an area of low concentration to high
concentration. The types of hypotonic solutions ... Show more content on Helpwriting.net ...
Women also have less body water than men and increase body fat can decrease water in the body.
Assess patient vital before, during and after administration of a crystalloid IV therapy. Continuously
monitor labs values (i.e. serum electrolytes) and notify the PCP of critical lab value. The nurse
should assess catheter site for signs of infiltration or other complication. Priority nursing diagnoses
include fluid volume excess, deficient Fluid Volume or water intoxication. When caring for patients,
the nurse should plan to monitor weight daily and monitor for edema and dehydration. Educate the
patients and their families about signs and symptoms of volume overload and dehydration, and
instruct the patient to notify the nurse if they develop breathing or if they feel their heart is beating
very fast, difficulties, swallowing, feel dizzy or malaise. The nurse should also elevate for the
effectiveness of

Diffusion Lab Report
William B. Walker
Professor Graves
Human Anatomy & Physiology Lab 1
Lab Report
Introduction
Diffusion is defined as the movement of molecules or ions from an area of a higher concentration to
an area where they are in lower concentration. The driving force for diffusion is kinetic energy. The
speed of diffusion is influenced by the molecular, temperature, bumping & bouncing off each other
creating equilibrium in the molecules. The atoms & molecules are the building blocks of cells. Cells
have selectively permeable membranes that only allow the movement of certain solutes or solutions.
Diffusion is key to the functions in a cell. Diffusion helps to transport nutrients to cells in the body
or plants. Water is an example of this movement like absorption of water into roots.
Osmosis is the diffusion of a solvent or movement of water through semi–permeable membrane
from a region of higher water or solvent into a potential lower region of water (hypertonic solute to
a region of lower water potential (hypertonic solute) to a region of lower water potential (hypertonic
solute). ... Show more content on Helpwriting.net ...
Hyperosmolality is usually related to hypernatremia and/or hyperglycemia. Identifying the cause
and carefully calculating the water deficit is crucial to appropriate management. Hyponatremia may
be hypertonic, isotonic, or hypotonic. When hypotonic, it may be hypervolemic, euvolemic, or
hypovolemic in nature. Determining the precise nature of the hyponatremia allows the clinician to
focus the therapy appropriately. The rate of development of hyponatremia is crucial to safe and
appropriate treatment. In acutely developing hyponatremia, hypertonic saline is required, whereas in
slowly developing hyponatremia, water restriction and slow correction is required to avoid the
syndrome of osmotic demyelination. Appropriate diagnosis and management of hyperkalemia and
hypokalemia are also

Essay on Young Woman's Death by Ingesting Exstasy
In their case study, "Fatal hyponatremia in a young woman after ecstasy ingestion," Kamyar
Kalantar–Sadeh, Minhtri Nguyen, Roger Chang, and Ira Kurtz present a 20–year old female, Asian–
American, college student who took multiple tablets of ecstasy and drank excessive amounts of
water at a party. This student was found the next morning, unresponsive, foaming at the mouth, with
rapid and shallow breathing, and a weak pulse. After being admitted into the emergency room, the
patient was determined to be hypothermic, hypoxemic, hypotensive, tachycardic, and in respiratory
distress. Initially, the patient had a sodium content of 117 mmol/l and a serum osmolality of 245
mOsm/kg. In order to treat the patient, throughout a 11 hour period, a ... Show more content on
Helpwriting.net ...
Both pulmonary edema, excessive fluid in the lungs, and cerebral edema, excessive fluid in the
brain, were reported for this patient. Because the blood–brain barrier is freely permeable to water,
the patient's neurons most likely swelled, causing a buildup of intracranial pressure, which may have
led to her coma. Further, the fact that the patient was found to be in respiratory distress supports the
conclusion that water had built up in her lungs as well. In the case study, two additional patients
with low sodium concentration in their cells were also presented in order to serve as a comparison to
the main case. The history of two Caucasian females, one 38 years of age and the other 24 years old
were presented. The 38–year–old female drank 25,250mL bottles of water (6.25L total) whilst
running a 64.4 km marathon. She suffered from confusion, headache, abdominal pain, nausea,
vomiting, diarrhea, shortness of breath, as well as pulmonary venous edema. Initially, the patient
had a sodium content of 121 mmol/l and a serum osmolality of 253 mOsm/kg. In order to treat the
patient, a hypertonic saline, normal saline, and 40mg of intravenous furosemide, a diuretic, were
administered after which her sodium content rose to of 125 mmol/l after 2.5 hours and 141 mmol/l
after 48 hours with no acute damage to cells. The 24–year–old female underwent an appendectomy
and received 5% dextrose infusion before and after

Hyponatremia

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