Electrolyte Balance - Sodium : Nursing Course


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The main symptoms that a patient with hypernatremia may present with are:

thirsty, tachycardic, and lethargic

Rationale: As sodium levels rise in the body, the cells become dehydrated. As this occurs, the body responds by trying to hold on to all the water possible. Typically, patients will present with signs and symptoms of dehydration. This includes complaints of feeling thirsty, and they may appear disoriented or lethargic. The heart rate will be increased, and the diastolic pressure is low. Muscle twitching and weakness may be present. Urine output is low, as the body does not want to lose any water. When left untreated, hypernatremia will result in seizures, come, or even death.


Treatment for severe hyponatremia is to administer:

hypertonic saline (3% NaCl)

Rationale: For situations of severe hyponatremia, treatment is to administer a hypertonic solution of 3% saline to correct the sodium deficit. This should be administered at a rate of 1-2 mL/kg per hour for the first 3-4 hours. The goal to elevate the sodium level to 120-125 mEq/L within 24-48 hours. It is important to not elevate the levels too quickly, as this could result in fluid overload. Symptoms of fluid overload are dyspnea, crackles in the lungs, and engorged veins.


When caring for a patient that has had vomiting and diarrhea for 2 days, you recognize that they are at a high risk of developing:

hypernatremia

Rationale:

A patient that has had an excessive amount of fluid intake is at risk of developing:

hyponatremia

Rationale:

The most abundant electrolyte in the extracellular fluid that plays an important role in fluid balance is:

sodium

Rationale:

Controlling fluid, electrolyte, and acid-base balances in the body is the job of the:

kidneys

Rationale:

The normal range of sodium that should be present in the body is:

135-145 mEq/L

Rationale:

Patients that have mild hyponatremia should be placed on:

fluid restrictions

Rationale:

When a patient is hypernatremic because of vomiting and diarrhea, the main treatment is:

fluid replacement

Rationale:

Severe hyponatremia, with a sodium level below 110mEq/L, can result in:

permanent neurological damage

Rationale:

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