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Hyponatraemia (Symptoms (Headache, Confuion, Coma, Seizures, "…
Hyponatraemia
135-145 mmol/L
Profound <125
Causes
Euvolaemic Urine Na >15
Excess Fluid Replace
Eg 5% Dextrose
SIADH
Neuro Conditions
Meningitis/Trauma/Haemorrhage/Tumour
Low Plasma/High Urine Osmolality + Sodium
Pneumonia
and
Small Cell Lung Cancer
Urine Osmolality >100mosmol/kg
Hypothyroidism
Psychogenic Polydipsia
Excess Consumption
Hypervolaemic
Failure
Congestive Cardiac
Renal
Liver
Nephrotic Syndrome
Cirrhosis w/ Ascites
Oedema
Hypovolaemic
Renal Losses
Diuretics
Non-Renal
Vomiting
Diahorrhea
Adrenal Insufficiency
Addison's Disease
Urine Na <15 mmol/L
Symptoms
Headache
Confuion
Coma
Seizures
"Failure" Symptoms
Treatment
HypoV
Fluid Challenge- 1L (0.9% Saline) over 2-4hrs
Iso
Symptomatic
Furosemide Diuresis
Hypertonic Saline
Asymptomatic
Fluid Restriction (<1L/day)
Hyper
Treat cause
H20 + Salt Restriction
Na should not increase by >12mmol/L in 24 hrs
Serum Osmolality
#
1st Check
"True"
HypoNa
Normal 275-295 mosmol/kg
PSEUDOHYPONa+
Hyperlipidaemia
Nephritic Syndrome
Acute Pancreatitis
Diabetes
Obstructive Liver
Hyperprotein
Multiple Myeloma