sodium

Question 1

Sodium is

Answer 1

main cation of ECF

Question 2

Function of sodium

Answer 2

generation and transmission of nerve impulse, muscle contractility, and regulation of acid base balance

Question 3

how does sodium leave the body?

Answer 3

urine, sweat, and feces

Question 4

what is the primary regulator of sodium balance

Answer 4

kidneys

Question 5

how does the kidneys regulate the ECF concentration of sodium

Answer 5

by excreting/retaining water under the influence of ADH

Question 6

What does Aldosterone do?

Answer 6

regulates sodium by promoting sodium reabsorption from renal tubule

Question 7

serum sodium levels reflect

Answer 7

ratio of sodium to water

Question 8

change in serum sodium levels can reflect

Answer 8

water and sodium imbalance

Question 9

Sodium Labs

Answer 9

135-145 mEq/L

Question 10

Hypernatremia- Pts who are at risk

Answer 10

(high sodium)
water loss/sodium gain
causes hyperosmolality

Question 11

what is hyperosmolality?

Answer 11

shift of water out of the cells (cellular dehydration)

Question 12

Hypernatremia- what does sodium retention cause?

Answer 12

RF

Question 13

Hypernatremia- how to get sodium

Answer 13

OTC meds, dietary sodium, corticosteroids

Question 14

Hypernatremia- water loss

Answer 14

water deprivation: cognitive impairment= pt cant communicate their needs
diabetes insipidus: problems with ADH (synthesis/release); causes diuresis (inc urine)

Question 15

Hypernatremia- CNS

Answer 15

early: restless, agitation, muscle twitch, dec alertness
later/severe: lethargy, weakness, dec DTRs (assess pt’s level of skeletal muscle strength)
as sodium inc (muscle and nerve controlled by sodium) less likely to respond to stimulus (severe)

Question 16

Hypernatremia- CV

Answer 16

dec contractility

Question 17

hypernatremia- ECF volume deficit

Answer 17

postural hypotension weakness

dec skin turgor

Question 18

Hyponatremia- Pts who are at risk

Answer 18

low serum sodium

water excess in relation to amount of sodium (dilutional hyponatremia)

Question 19

What causes hyponatremia?

Answer 19

diaphoresis (sweating), draining wounds, excessive D/V and trauma with significant blood loss

Question 20

What does hyponatremia cause?

Answer 20

hypoosmolality with shift of water into the cell

Question 21

hyponatremia- increase water (FVE)

Answer 21

excessive ADH
SIADH (result in dilutional hyponatremia caused by abnormal water retention)
CHF/HF- heart isnt pumping; body retaining fluid

Question 22

hyponatremia- inc excretion(fluid and sodium loss)

Answer 22

renal loss
GI loss- sodium, potassium, chloride (lose electrolytes- diarrhea)
hormonal- lack of aldosterone

Question 23

What is due to hyponatremia?

Answer 23

cellular swelling

first manifested in CNS

Question 24

what does excess water for hyponatremia do?

Answer 24

lowers plasma osmolality, shifting fluids into brain cells;

causing: irritability, headache, confusion, seizures, and coma

Question 25

hyponatremia- neurological

Answer 25

cerebral edema (inc ICP); confusion, HA

Question 26

Hyponatremia- CV

Answer 26

hypervolemia (too much fluid volume in blood) | hypovolemia

Question 27

hyponatremia- musculoskeletal

Answer 27

dec DTR (patellar & achillies)

Question 28

hyponatremia- respiratory

Answer 28

skeletal muscle weakness can affect respiratory

Question 29

hyponatremia- GI

Answer 29

smooth muscle- inc motility | cramping, N/V

Question 30

hypernatremia- nursing Dx- risk

Answer 30

risk for injury: alt sensorium and seizure; FVD related to excessive intake of sodium and/or water loss; electrolyte imbalance impaired memory

Question 31

hypernatremia- nur Dx- potential complications

Answer 31

seizure and coma leading to irreversible brain damage

Question 32

hypernatremia- nur Dx-Dec CO

Answer 32

dec contractility

Question 33

hypernatremia- nur Dx-falls

Answer 33

skeletal muscle weakness

Question 34

hyponatremia- nur Dx-risk for:

Answer 34

acute confusion alt sensorium and dec LOC electrolyte imbalance- excessive loss of sodium and/or excessive intake or retention of water

Question 35

hypernatremia- nur Dx-potential complications

Answer 35

severe neurologic changes

Question 36

hypernatremia- nur Dx

Answer 36

nausea, acute confusion, fatigue (skeletal muscle weakness), falls, alt nutrition, knowledge deficit, activity intolerance, imbalance fluid volume, dec CO

Question 37

hypernatremia- Goals: treat-

Answer 37

treat primary water deficit, fluid replacement (orally/IV) with isotonic/hypotonic fluids (5DW) dilute sodium concentration with sodium free IV fluids

Question 38

hypernatremia- Goals: monitor-

Answer 38

I&O: losing/gaining fluids(weight) LOC sodium levels: if you reduce serum sodium levels, it can cause a rapid shift of water back into the cell (cerebral edema and neurologic complications) restrict sodium intake

Question 39

hyponatremia- Goals: treat-

Answer 39

fluid is often only treatment if seizure; small amounts of IV hypertonic solution abnormal fluid loss: fluid replacement with sodium-containing solutions

Question 40

hyponatremia- Goals/treat- administer

Answer 40

``` administer: saline IVF osmotic diuretics(mannitol- osmitrol) ```