sodium + discussion grp

what is antidiuretic hormone also know as

vasopressin

where is antidiuretic hormone made, why

made in the hypothalamus of the brain; restrict loss of water in the urine and to cause vasoconstriction in order to raise the blood pressure

what are the two functions of antidiuretic hormone

• restrict water loss in the urine

• cause vasoconstriction in order to raise the blood pressure

how does ADH work in the kidney

causes inc aquaporin channels in the collecting duct cells so water can be reabsorbed out of the urinary filtrate and back into the bloodstream

what can serum sodium tell us

reflects the total body water; does not tell us the total amount of sodium in the body

what are the components of a basic metabolic panel (BMP)

what is hyponatremia

low serum sodium → total body water in in excess

what is hypernatremia

serum sodium is high → total body water is deficient

define edema in terms of sodium

too much salt; water follows sodium and if you have too much salt, this manifests as too much fluids in the ECS → edema

define volume depletion in terms of sodium

too little salt; if you have too little salt, you will have too little water → hypotension, poor skin turgor

how would you address a pt that is deemed hyponatremia

stop drinking/administering water, inc diuresis, turn off ADH w medications

how would you address a pt that is deemed hypernatremia

drink/administer water, dec diuresis, turn on ADH w medications

how would you address a pt that is has edema

dec salt intake, administer diuretic, inc plain water intake

how would you address a pt that is deemed volume depleted

inc salt intake and water, administer salt in the form of 0.9% normal saline

what are the two basic conditions that can cause hyponatremia

• drank a tremendous amount of water

• kidneys are not able to excrete all the water

what are the two main cases for the kidneys to not get rid of extra water

• excess antidiuretic hormone

• kidney is not working right

what are the two basic conditions that can cause hypernatremia

• not drinking enough water

• body is peeing out too much water

can hyponatremia or hypernatremia cause brain swelling

hyponatremia

why does hyponatremia cause brain swelling

have a low osmolarity in the ESV → water will go in areas of higher osm so it will go into the ICV → in cases of the brain, the fluid will have nowhere else to go so the cells will continue to expand → brain swelling → neurological problems

will ADH levels be high or low in someone that is volume depleted and hyponatremic, why

volume depletion overrides osmolality (hyponatremic) for ADH release

in someone who is volume depleted and deemed hyponatremic, what is the appropriate tx

give normal saline→ their salt deficit will be corrected and add volume will turn off the stimulation of ADH, allowing them to pass a dilute urine and return their intracellular volume to normal