Hyponatremia

sodium below ___ indicates hyponatremia

135 mEq/L

core fluid shift in hyponatremia

water moves into cells & cells swell

• brain cells at risk of bursting

what is dilutional hyponatremia?

low sodium levels due to excess water diluting it

GI causes of hyponatremia

• vomiting

• GI suction

• diarrhea

• ileostomy

renal causes of hyponatremia

• kidney disease

• diuretics (especially thiazides)

skin related causes of hyponatremia

• burns

• wound drainage

• heavy sweating

other contributors to hyponatremia

• inadequate salt intake

• excessive oral water intake

• too much IV hypotonic fluid

diseases that cause edema linked to hyponatremia

congestive heart failure, cirrhosis

who is at higher risk for hyponatremia?

older adults

why are older adults at higher risk of hyponatremia?

chronic illnesses, diuretics use, or low salt intake

why is hyponatremia dangerous neurologically?

it can cause brain cell swelling, which also causes:

• confusion

• seizures

• coma

• death (severe)

how does hyponatremia impact level of consciousness/brain?

• decreased alertness, (stupor)

• possible seizures

• trouble concentrating

how does hyponatremia affect the GI system?

• abdominal cramping

• overactive bowel sounds

• loss of appetite

• nausea or vomiting may occur

how does hyponatremia impact your energy?

loss of energy, lethargy/stupor

tendon reflexes in hyponatremia?

deep tendon reflexes diminished

how is blood pressure impacted by hyponatremia?

lower blood pressure (hypotension)

how does hyponatremia impact blood pressure when standing?

it causes orthostatic hypotension

describe bowel sounds in hyponatremia

overactive bowel sounds

late respiratory sign in hyponatremia

shallow respirations due to the effect on skeletal muscles

why can hyponatremia slow breathing?

skeletal muscle weakness includes respiratory muscles

• leads to shallow respirations

how does hyponatremia impact the muscles?

spasms and twitching

first monitoring steps for hyponatremia

• measure i&o, daily weights, and vital signs with respiratory focus

• orthostatics

• watch for GI symptoms and bowel changes

what risk precautions should we put hyponatremic patients on?

risk for falls, risk for seizures

what do we do for patients with dilutional hyponatremia?

enforce fluid restriction as prescribed