NOTE 5

 Electrolyte imbalances

1 hyponatremia

Serum sodium level less than 135mEq /L

-causes

Increased sodium excretion

 -diaphoresis

 -diuretics

 -vomiting

 -wound drainage

 -renal disease

Inadequate sodium intake

Dilution of serum sodium

 -renal failure

 -DI

-assessment

Normovolemic

Rapid pulse rate

Normal bp

Hypervolemic

Thready weak pulse,hypotension

Flat neck veins

Normal cvp(3-8mm hg)

Hypervolemic

Bounding pulse

Normal /elevated BP

Normal/ elevated CVP

·        -shallow respirations

·        -neuro muscular

  Generalized skeletal muscle weakness

  Diminished deep tendon reflexes

·        Cerebral function

  Headache

  Personality change

  Confusion

  Seizure

  Coma

·        GI

  Increased motility

  Hyper active bowel sounds and nausea

·        Renal

  Decreased  urine specific gravity

  Increased urine output

 

Interventions

Hyponatremia associated with   hypovolemia-iv NaCl  

                                    ………    hypervolemia- osmotic diuretics

                              …………….    ADH –lithium /demiclocycline