front 1 Sodium (Na+) | back 1 135-145 mEq/L Essential for acid-base, fluid balance, active & passive transport mechanism, irritability & CONDUCTION of nerve-muscle tissue |
front 2 Hypernatremia: >145 mEq/L Signs & Symptoms | back 2 FRIED SALT (Big & Bloated) Flushed skin Restless, anxious, confused, irritable Increased BP & fluid retention Edema (Pitting) Decreased urine output Skin flushed & dry Agitation Low-Grade fever Thirst (dry mucous membranes) |
front 3 Hypernatremia Risk Factors: | back 3 Increased sodium intake - excess oral sodium ingestion - excess administration of IV fluids w/ sodium - hypertonic IV fluids Loss of fluids - fever - watery diarrhea - diabetes insipidus - excessive diaphoresis - infection Decreased sodium excretion - kidney problems HEMOCONCENTRATION = INCREASED SODIUM |
front 4 Hypernatremia Interventions: | back 4 If due to loss: - administer IV infusion If the cause is inadequate renal excretion of sodium - give diuretics that promote sodium loss Restrict sodium & fluid intake as prescribed |
front 5 Hyponatremia: <135 mEq/L Signs & Symptoms: | back 5 HYPOVOLEMIC / HYPONATREMIA: DECREASE OF FLUID & SODIUM HYPERVOLEMIC / HYPONATREMIA: INCREASE BODY WATER THAT IS GREATER THAN SODIUM SALT LOSS Stupor/coma Anorexia ( nausea/ vomiting) Lethargy (weakness/ fatigue) Tachycardia (thready pulse) Limp muscles Orthostatic hypotension seizures/ headache stomach cramping (hyperactive bowels) |
front 6 Hyponatremia Risk Factors: | back 6 Increased sodium excretion 4 D's -diaphoresis (high fever) -diarrhea & vomiting -drains (NGT suction) -diuretics (thiazide & loop diuretics) SIADH Adrenal insufficiency (adrenal crisis) Inadequate sodium intake -fasting, NPO, low-salt diet -kidney disease heart failure |
front 7 Hyponatremia Interventions: | back 7 ADD SALT Administer IV sodium chloride infusions (only if due to hypovolemia) Diuretics (if due to hypervolemia) Hyponatremia-high fluids & low salt = hemodilution Daily weights: where sodium goes, water flows Safety (orthostatic hypotension AKA risk for falls) Airway protection (NPO) Do not give food to a lethargic, confused client can lead to an increased risk for aspiration Limit water intake: hypervolemic hyponatremia (high fluid & low salt) Teach about foods high in sodium (canned food, packaged/ processed meats |