Chapter 17: Fluids and Electrolytes- Hyponatremia Flashcards
What are the surgical causes of the following type:
Hypovolemic
- Diuretic excess
- hypoaldosteronism
- vomiting
- NG suction
- burns
- pancreatitis
- diaphoresis
What are the surgical causes of the following type:
Euvolemic
- SIADH
- CNS abnormalities
- drugs
What are the surgical causes of the following type:
Hypervolemic
- Renal failure
- CHF
- liver failure (cirrhosis)
- iatrogenic fluid overload(dilutional)
What are the signs/symptoms?
- Seizures
- coma
- nausea
- vomiting
- ileus
- lethargy
- confusion
- weakness
What are the treatments of the following type:
Hypovolemic
NS IV, correct underlying cause
What are the treatments of the following type:
Euvolemic
SIADH: furosemide and NS acutely, fluid restriction
What are the treatments of the following type:
Hypervolemic
Dilutional: fluid restriction and diuretics
How fast should you increase the sodium level in hyponatremia?
Guideline is <12 mEq/L per day
What may occur if you correct hyponatremia too quickly?
Central pontine myelinolysis!
What are the signs of central pontine myelinolysis?
- Confusion
- Spastic quadriplegia
- Horizontal gaze paralysis
What is the most common cause of mild postoperative
hyponatremia
Fluid overload
What is it Pseudohyponatremia?
Spurious lab value of hyponatremia as a result of:
- hyperglycemia
- hyperlipidemia
- hyperproteinemia
