Flashcards in Hyponatraemia Deck (6):
What are some causes of hyponatraemia?
- Administration of hypotonic fluids (eg 0.18% Na)
- Conditions with impaired free water secretion and high ADH levels eg sepsis, meningitis, surgery
- Relative fluid intake excess in patients taking exogenous ADH
- GI loss
- Adrenal insufficiency
- Defect in renal tubular absorption
- Psychogenic polydipsia
What is the definition of hyponatraemia?
Serum Na less than 135mmol/L
When do symptoms occur usually? What are some?
When Na is less than 125mmol/L
- Lethargy, irritibility
- Nausea, vomiting
- Reduced conscious state
How else do you assess hyponatraemia?
Assess volume state on examination
Serum creatinine, K, glucose, urea, chloride
Urine osmolarity and Na
How do you manage hyponatraemia
If symptomatic - Seizures and CNS depression
- ICU referral, 4ml/kg 3% Na solution until Na is 125 and above
- Intravenous anti-convulsants as clinically indicated
If not symptomatic
- Depending on fluid status either restrict water intake (if euvolaemic) or use normal maintenance fluids (if dehydrated)