Please enable JavaScript.

Coggle requires JavaScript to display documents.

Sodium :peanuts: (Think hypotonic (Serum Osm (normal? (Isotonic…

- - - - Isotonic hyponatremia (pseudohyponatremia)
        
        problem w/ fats/proteins, nothing else to know
    - - Hypertonic hyponatremia
        
        caused by something in this eq or something else. Eq figures things that are supposed to be in body, There are other osmotic compounds that can be ingested (sugar alcohols)
        
        :arrow_up:BUN/Glu elevated
        
        Na may decrease
        
        Tx: Simply dialyze to remove the problem/ or insulin for Glu
        
        Diabetics: 100blood Glu = 1.6Na, for ea 100bG above 100
        
        :pencil2: 130Na needs correcting to 136.5Na
        
        500bG: 4 x 1.6Na = 6.5Na
    - - Hypotonic hyponatremia
        
        Hx and PEx to decide Volume Status
        
        Volume overload
        
        correct Na via Diuresis
        
        JVD, crackles, CHF
        
        Volume depleted
        
        Correct Na via fluids (rescuscitation)
        
        Sunken eyes, skin tenting, history of burns
        
        Euvolemic
        
        hard to determine in real life
        
        eg sepsis, no great
        
        RATS mnemonic
        
        Renal tubular Acidosis
        
        UA and electrolytes
        
        Addisons
        
        cortisol
        
        Thyroid
        
        TSH
        
        SIADH
        
        Dx of exclusion
        
        Use volume restriction
        
        Gentle diuresis
        
        break glass if all fails: demeclocycline
        
        On wards: look for Urine Na , Urine Osm (not emphasized on Shelf)
        
        Urine Na ~ aldosterone
        
        Urine Osm ~ ADH (posterior pituitary lecture)
- - - - 1/2 normal saline works for moderate