HypoNAtremia

Question 1

What degree of hyponatremia would indicate pause for surgery?

Answer 1

Less than 125 mg/dL

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Question 2

What are some conditions that can cause hyponatremia?

Answer 2

• over fluid-resuscitation
• ↑ endog vasopressin (↑ H2O reabsorption)

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Question 3

How to treat hyponatremia?

Answer 3

This is highly dependent on underlying pathology.

• Treatment of underlying cause
  (check volume status)
• NS
• Hypertonic Saline
• Lasix
• Mannitol

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Question 4

What pathology could occur with rapid over-correction of hyponatremia?

Answer 4

Osmotic Demyelination Syndrome (“Locked-in Syndrome”)

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Question 5

S/S of Hyponatremia?
What is the clinical presentation?
What are the most severe consequences?

Answer 5

Clinical presentation: Neurological

Most severe consequences: seizures, coma, and death

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Question 6

How would you treat Hyponatremic seizures?

Answer 6

3-5ml/kg of 3% over 20 min, until seizures resolve

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Question 7

What causes Hypovolemia, Euvolemia, and Hypervolemia with Hyponatremia?

Answer 7

Hypovolemic = Na+/H20 loss (diuretics, gi loss, burns, trauma)

Euvolemic= salt restriction & endocrine related
- Hypothyroid
- SIADH (holding on to H20 >Na+)

Hypervolemic= ARF/CKD, heart failure

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