Sodium (Hypo & Hypenatremia) Fluid and Electrolytes

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Learn more: http://bit.ly/nrsngacademy Sodium (Na+) is a vital electrolyte within the body. This presentation, from NRSNG Academy, outlines the role of Sodium in the body.

Health & Medicine

1www.nrsng.com© NRSNG, LLC. All rights reserved.
SODIUM - Na+
Hyponatremia & Hypernatremia

2www.nrsng.com© NRSNG, LLC. All rights reserved.
SODIUM
● NORMAL RANGE:
○ 135-145 mEq/L
● MAIN FUNCTIONS:
○ Most abundant extracellular cation
○ Controls fluid distribution between ICF and ECF
■ Osmolarity
○ Muscle contraction
○ Nerve Impulses

3www.nrsng.com© NRSNG, LLC. All rights reserved.
Hypoaldosteronism
HYPONATREMIA - CAUSES
ACTUAL
Wound Drainage
Low Na Diet
Diuretics
Sweating
RELATIVE
Water Intoxication
Freshwater Submersion
Psychogenic Polydipsia
Hypotonic Fluids
SIADH

4www.nrsng.com© NRSNG, LLC. All rights reserved.
● Neuro → Behavior changes, ↑ ICP
● MS → weakness
● GI → hyperactive
● CV → depends on volume status
○ ↓ = weak pulse, ↓ BP
○ ↑ = bounding pulse, ↑ BP
HYPONATREMIA - SYMPTOMS

5www.nrsng.com© NRSNG, LLC. All rights reserved.
HYPONATREMIA - TREATMENT
STOP Na-Wasting Diuretics
IV Fluids
Osmotic Diuretics
Replace SLOWLY!!
Dietary Changes

6www.nrsng.com© NRSNG, LLC. All rights reserved.
HYPERNATREMIA - CAUSES
ACTUAL
Oral Ingestion
Hypertonic Saline
Cushing’s Syndrome
Steroids
RELATIVE
Fever
Hyperventilation
Dehydration
Infection
NPO

7www.nrsng.com© NRSNG, LLC. All rights reserved.
● Neuro → r/t cellular dehydration
○ Hypovolemic → CRANKY
○ Hypervolemic → COMA
● MS → twitching
● CV → ↓ contractility
● S/S Dehydration
HYPERNATREMIA - SYMPTOMS

8www.nrsng.com© NRSNG, LLC. All rights reserved.
HYPERNATREMIA -
TREATMENT
Hypotonic Fluids
Na-Wasting Diuretics
Dietary Changes
Bring levels down SLOWLY

9www.nrsng.com© NRSNG, LLC. All rights reserved.
KEY POINTS
Normal Value
Main Functions Fluid Balance, Nerve Impulses, Muscle Contraction
Hyponatremia Actual v. Relative → Cerebral edema. Replace SLOWLY
Hypernatremia Actual v. Relative → Cellular dehydration. Hypotonic + Free Water
Top Priorities Treat the cause, Protect the BRAIN!
01
02
03
04
05
135 - 145 mEq/L

10www.nrsng.com© NRSNG, LLC. All rights reserved.
HAPPY
NURSING!!

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Sodium (Hypo & Hypenatremia) Fluid and Electrolytes

2. 2www.nrsng.com© NRSNG, LLC. All rights reserved. SODIUM ● NORMAL RANGE: ○ 135-145 mEq/L ● MAIN FUNCTIONS: ○ Most abundant extracellular cation ○ Controls fluid distribution between ICF and ECF ■ Osmolarity ○ Muscle contraction ○ Nerve Impulses

3. 3www.nrsng.com© NRSNG, LLC. All rights reserved. Hypoaldosteronism HYPONATREMIA - CAUSES ACTUAL Wound Drainage Low Na Diet Diuretics Sweating RELATIVE Water Intoxication Freshwater Submersion Psychogenic Polydipsia Hypotonic Fluids SIADH

4. 4www.nrsng.com© NRSNG, LLC. All rights reserved. ● Neuro → Behavior changes, ↑ ICP ● MS → weakness ● GI → hyperactive ● CV → depends on volume status ○ ↓ = weak pulse, ↓ BP ○ ↑ = bounding pulse, ↑ BP HYPONATREMIA - SYMPTOMS

7. 7www.nrsng.com© NRSNG, LLC. All rights reserved. ● Neuro → r/t cellular dehydration ○ Hypovolemic → CRANKY ○ Hypervolemic → COMA ● MS → twitching ● CV → ↓ contractility ● S/S Dehydration HYPERNATREMIA - SYMPTOMS

9. 9www.nrsng.com© NRSNG, LLC. All rights reserved. KEY POINTS Normal Value Main Functions Fluid Balance, Nerve Impulses, Muscle Contraction Hyponatremia Actual v. Relative → Cerebral edema. Replace SLOWLY Hypernatremia Actual v. Relative → Cellular dehydration. Hypotonic + Free Water Top Priorities Treat the cause, Protect the BRAIN! 01 02 03 04 05 135 - 145 mEq/L

Sodium (Hypo & Hypenatremia) Fluid and Electrolytes

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