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adult health exam 1 > sodium > Flashcards

sodium Flashcards

1
Q

Sodium is

A

main cation of ECF

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2
Q

Function of sodium

A

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

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3
Q

how does sodium leave the body?

A

urine, sweat, and feces

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4
Q

what is the primary regulator of sodium balance

A

kidneys

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5
Q

how does the kidneys regulate the ECF concentration of sodium

A

by excreting/retaining water under the influence of ADH

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6
Q

What does Aldosterone do?

A

regulates sodium by promoting sodium reabsorption from renal tubule

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7
Q

serum sodium levels reflect

A

ratio of sodium to water

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8
Q

change in serum sodium levels can reflect

A

water and sodium imbalance

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9
Q

Sodium Labs

A

135-145 mEq/L

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10
Q

Hypernatremia- Pts who are at risk

A

(high sodium)
water loss/sodium gain
causes hyperosmolality

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11
Q

what is hyperosmolality?

A

shift of water out of the cells (cellular dehydration)

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12
Q

Hypernatremia- what does sodium retention cause?

A

RF

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13
Q

Hypernatremia- how to get sodium

A

OTC meds, dietary sodium, corticosteroids

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14
Q

Hypernatremia- water loss

A

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

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15
Q

Hypernatremia- CNS

A

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)

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16
Q

Hypernatremia- CV

A

dec contractility

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17
Q

hypernatremia- ECF volume deficit

A

postural hypotension weakness

dec skin turgor

18
Q

Hyponatremia- Pts who are at risk

A

low serum sodium

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

19
Q

What causes hyponatremia?

A

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

20
Q

What does hyponatremia cause?

A

hypoosmolality with shift of water into the cell

21
Q

hyponatremia- increase water (FVE)

A

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

22
Q

hyponatremia- inc excretion(fluid and sodium loss)

A

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

23
Q

What is due to hyponatremia?

A

cellular swelling

first manifested in CNS

24
Q

what does excess water for hyponatremia do?

A

lowers plasma osmolality, shifting fluids into brain cells;

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

25
Q

hyponatremia- neurological

A

cerebral edema (inc ICP); confusion, HA

26
Q

Hyponatremia- CV

A

hypervolemia (too much fluid volume in blood)

hypovolemia

27
Q

hyponatremia- musculoskeletal

A

dec DTR (patellar & achillies)

28
Q

hyponatremia- respiratory

A

skeletal muscle weakness can affect respiratory

29
Q

hyponatremia- GI

A

smooth muscle- inc motility

cramping, N/V

30
Q

hypernatremia- nursing Dx- risk

A

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

impaired memory

31
Q

hypernatremia- nur Dx- potential complications

A

seizure and coma leading to irreversible brain damage

32
Q

hypernatremia- nur Dx-Dec CO

A

dec contractility

33
Q

hypernatremia- nur Dx-falls

A

skeletal muscle weakness

34
Q

hyponatremia- nur Dx-risk for:

A

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

35
Q

hypernatremia- nur Dx-potential complications

A

severe neurologic changes

36
Q

hypernatremia- nur Dx

A

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

37
Q

hypernatremia- Goals: treat-

A

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

38
Q

hypernatremia- Goals: monitor-

A

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

39
Q

hyponatremia- Goals: treat-

A

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

40
Q

hyponatremia- Goals/treat- administer

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

adult health exam 1 (6 decks)

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