Hyponatraemia new Flashcards
(16 cards)
What are the three types of hyponatraemia?
Hypovolaemic (↓H₂O, ↓Na)
Euvolaemic (↑H₂O, -Na)
Hypervolaemic (↑H₂O, ↑Na)
What should be avoided in the management of severe symptomatic hyponatraemia?
Over-rapid correction and vaptans.
How should hypervolaemic hyponatraemia be managed?
Fluid and salt restriction, diuretics, and treat the underlying condition.
What is the management for euvolaemic hyponatraemia, such as SIADH?
Fluid restriction (typically 500–750 mL/day) and treat the underlying cause.
What is the management approach for hypovolaemic hyponatraemia?
Restore volume with isotonic fluids (0.9% saline or balanced crystalloids).
What is the recommended rate of sodium correction in hyponatraemia management?
Limit sodium increase to no more than 10 mmol/L in the first 24 hours and 8 mmol/L per 24 hours thereafter.
What is the typical dosing for hypertonic saline in hyponatraemia management?
150 mL of 3% saline over 20 minutes, repeated up to twice within the first hour to achieve a 5 mmol/L increase in serum sodium.
What is the immediate treatment for severe or moderately severe symptomatic hyponatraemia?
Administer intravenous hypertonic saline (3% sodium chloride) as intermittent boluses.
What are the serum sodium level classifications for hyponatraemia?
Mild: 130–135 mmol/L, Moderate: 125–129 mmol/L, Profound: <125 mmol/L.
What are severe or moderately severe symptoms of hyponatraemia?
Severe or moderately severe symptoms include seizures, reduced consciousness, vomiting, cardiorespiratory distress, or coma.
What should be done if symptoms persist after initial correction of hyponatraemia?
Give an additional bolus to raise sodium by 1 mmol/L.
When should hypertonic saline be stopped during treatment?
Stop hypertonic saline once the 5 mmol/L rise is achieved or clinical improvement occurs.
What should be done if over-correction of sodium occurs?
Active measures (e.g., desmopressin, free water) should be considered to re-lower sodium safely.
What is essential during the treatment of hyponatraemia?
Regular serum sodium checks.
How often should serum sodium be monitored during treatment?
Monitor serum sodium frequently (every 4–6 hours initially).
Where should patients with severe symptoms or profound hyponatraemia be managed?
In a high-dependency setting with close monitoring.
