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IM 2 > Sodium -exam 5 > Flashcards

Sodium -exam 5 Flashcards

1
Q

what are the 5 functions of sodium?

A
  1. maintain Bp
  2. blood volume
  3. pH balance (acid base)
  4. controlling nerve impulses
  5. stimulating muscle contractions
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2
Q

Na is a big impact on the bodys _ _

A

fluid balance

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3
Q

Na is a major electrolyte in _ _

A

ECF

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4
Q

Na controls

A

water balance

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5
Q

Na is regulated by?

A
  • ADH
  • Aldosterone
  • sodium and potassium pump
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6
Q

What three things do we need to think of when we think sodium?

A
  • Think brain, Neuro checks, and safety
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7
Q

lab value range for Na

A

135-145mEq/L

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8
Q

Impaired water excretion caused by inability to suppress secretion of ADH; water retention causes dilutional hyponatremia

A

SIADH

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9
Q

water excess in relation to the amount of sodium

A

dilutional hyponatremia

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10
Q

retaining fluid and sodium causing hemodilution of Na+

A

water intoxication

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11
Q

excessive fluid intake without physiologic stimuli

A

psychogenic polydipsia

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12
Q

shifts solutes into the cell

A

hypotonic fluids

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13
Q

anything below what is hyponatremia

A

less then 135

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14
Q

hypotonic fluids shifts fluid where?

A

into the cell

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15
Q

hypertonic fluids shift where?

A

out of the cell

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16
Q

common causes of hyponatremia from loss of sodium rich body fluids include? (4)

A
  • draining wounds
  • diarrhea
  • vomiting
  • primary adrenal insufficiency
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17
Q

SIADH results in dilutional hyponatremia caused by

A

abnormal retention of water

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18
Q

mild hyponatremia - symptoms

A
  • headache
  • irritability
  • difficulty concentrating
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19
Q

severe hyponatremia - symptoms

A
  • confusion
  • vomiting
  • seizures
  • and even coma
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20
Q

what fluid would we give to a patient after fluid loss?

A

isotonic sodium containing solutions

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21
Q

what two medications can be given to a patient with hyponatremia?

A
  • loop diuretics
  • demeclocycline
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22
Q

what IV solution can we give to a pt with hypernatremia?

A

3% sodium chloride

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23
Q

what is essential when monitoring a pt with hypernatremia?

A

I&O

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24
Q

what are some mild symptoms related to hyponatremia?

A

headache, N/V, fatigue

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25
Q

what are some moderate symptoms related to hyponatremia

A

lethargy, weakness, altered LOC

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26
Q

what are some severe symptoms of hyponatremia ?

A

sz, brainstem herniation, respiratory arrest, and death

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27
Q

No volume loss

A

Euvolemic

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28
Q

Low Na with ECF volume normal

A

Euvolemic

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29
Q

Na loss with ECF volume depletion

A

Hypovolemic

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30
Q

Na loss with increased ECF volume

A

hypervolemic

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31
Q

inadequate sodium intake can be caused by

A
  • fasting
  • NPO status
  • Low Na in diet
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32
Q

Increased Na excretion can be caused by

A

-diarrhea, diuretics, drainage, diaphoresis
-vomiting
- kidney disease
- Addisons

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33
Q

Sodium loss and water retention

A

Hypoaldosteronism (addison’s)

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34
Q

we replace sodium slowly or quickly? why?

A

slowly! if given to rapid can lead to neruo damage!

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35
Q

what is the MAXimum per hour

A

0.5mEq/L

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36
Q

when giving sodium slowly how much can the lab value sodium go up in the body in a 24 hr period?

A

6-12 pts

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37
Q

how often do we check sodium levels?

A

2-4 hours

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38
Q

with a patient experiencing hypovolemic what saline do we given to correct fluid volume status and Na+?

A

0.9% NS

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39
Q

what solution do we use for extremely low Na+

A

3% NS

40
Q

When giving 3% NS where must we give it through and why?

A

central line because it is highly caustic on veins

41
Q

this med excretes water but not Na+, what am I?

A

mannitol

42
Q

give osmotic diuretics and fluid restriction

A

hypervolemic

43
Q

Causes SIADH

A

Euvolemic

44
Q

in severe hyponatremia - what is this lab value?

A

less than 120mEq/L

45
Q

with SEVERE hyponatremia what do we administer and what rate?

A

administer 3% saline IV SLOWLY

46
Q

what do we insert into a patient for strict I&O

A

indwelling catheter

47
Q

if Na is overcorrected too quickly what syndrome can occur?

A

demyelination syndrome

48
Q

causing damage to nerve cells in the brain

A

demyelination syndrome

49
Q

causes your body to retain too much water and commonly leads to hyponatremia

A

SIADH

50
Q

this upset electrolytes, especially sodium. what am i ?

A

SIADH

51
Q

high levels of ADH retain water - this is caused by

A

SIADH

52
Q

a pt has a decreased sodium and increased water retention - what might this be caused by?

A

SIADH

53
Q

3 causes to SIADH?

A
  • small cell lung cancer
  • severe brain trauma
  • sepsis infections of brain
54
Q

vasopressor drugs block what

A

ADH

55
Q

ADH is produced in the area of the brain called?

and secreted into the blood by the

A

hypothalamus; pituitary gland

56
Q

ADH is released by the

A

pituitary gland

57
Q

with SIADH there is too much - in the blood

A

water

58
Q

too much ADH

A

hyponatremia

59
Q

synthetic ADH

A

desmopressin, Vasopressin

60
Q

ADH decreases - -

A

urine output

61
Q

ADH does what to the BP

A

Increased

62
Q

if a patient is experiencing an headache what should this alert you to

A

SIADH

63
Q

Low Na can lead to

A

seizures and death!

64
Q

How much fluid can a person have ?

A

800-1000ml/day

65
Q

blocks effect of ADH resulting in more dilute urine

A

demeclocycline

66
Q

medications and caffeine can be a

A

diuretic

67
Q

increasing oral sodium intake what can you do?

A

salt tablets, bacon, processed foods

68
Q

what is important in the treatment of a pt with SIADH

A

daily weight and I&O

69
Q

cause kidneys to retain sodium

A

corticosteroids

70
Q

may occur with inadequate water intake, excess water loss

A

hypernatremia

71
Q

excess sodium intake with inadequate water intake can lead to

A

hypernatremia

72
Q

primarily the results of water shifting out of cells into ECF with resultant dehydration and shrinkage of cells

A

hypernatremia

73
Q

in primary water deficit , what fluid is given to replace

A

with isotonic solutions such as 0.9 % sodium chloride

74
Q

if a patient has sodium excess what would you give fluid wise

A

expect diluting the high sodium concentration with sodium free IV fluids, such as 5% dextrose in water

75
Q

occurs due to prolonged exposure to glucocorticoids or a tumor producing excessive cortisol by adrenals

A

cushings syndrome

76
Q

high sodium and water retention

A

hyperaldosteronism

77
Q

severe hypernatremia is defined as sodium levels ??

A

> 160

78
Q

examples of sodium gain include IV admin of what?

A

hypertonic saline or bicarb

79
Q

the serum level for hypernatremia should not decrease more then what

A

8-15 pts

80
Q

quickly reducing levels can cause rapid shift in water back into the cells, causing what

what condition is this? hyper or hypo?

A

cerebral edema - hypernatremia

81
Q

in a patient with hypernatremia and increased sodium intake what might the pt be ingesting or getting?

A

too many processed foods
hypertonic solutions (3%NS or 5%NS)
alka seltzer, aspirin

82
Q

in a pt with hypernatremia and they have a decrease in water intake what might be causing this

A

fasting
NPO status

83
Q

hemoconcentration

A

increased water loss

84
Q

in a patient with hypernatremia and they have increased water loss what might be causing this

A

dehydration - too much water loss and Na gain
infection
diabetes insipidus

85
Q

with a patient with hypernatremia you need to bring the sodium levels down slowly why?

A

rapid correction can lead to sz due to rapid fluid shifts in the brain

86
Q

what solutions do we give to a pt experiencing hypernatremia

A

hypotonic solutions, 1/2 NS, D5W

87
Q

what are the important interventions associated with hypernatremia

A
  • patient safety b/c they are confused and agitated
  • weigh daily
  • I&O
  • neuro checks/precautions
88
Q

what moderate symptoms of hypernatremia should we watch for

A
  • confusion
  • swollen and dry red tongue
  • muscle twitching
  • thirst
89
Q

what severe symptoms of hypernatremia should we watch for?

A
  • N/V
  • increased muscle tone
  • seizures
  • coma
90
Q

ADH (vasopressin) deficiency

A

Diabetes Insipidus

91
Q

your patient presents with increased sodium and diluted urine what condition might your patient have

A

Diabetes Insipidus

92
Q

causes of diabetes insipidus

A
  • damage to brain
  • tumors
  • trauma
93
Q

2 symptoms of diabetes insipidus

A

polydipsia
polyuria

94
Q

SIadh

A

Soaked Inside

95
Q

DI

A

dry inside

96
Q

your patient has a high urine output and high sodium and they are at risk for hypovolemic shock what condition am i

A

Diabetes insipidus

97
Q

your patient has a low urinary output, low sodium level, and is at risk for seizures what condition am i?

A

SIADH

IM 2 (17 decks)

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