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Hyponatraemia, Hypernatraemia - Coggle Diagram
Hyponatraemia
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aetiology
hypovolaemic; diarrhoea, burns, diuretics and addison's disease, adrenal insufficiency
euvolaemic; hypothyroidism, Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which the body makes too much antidiuretic hormone (ADH)
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signs
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hypervolaemic: pulmonary oedema, raised JVP, peripheral oedema
hypovolaemic; abnormal cap refil, dehydration, tachycardic
symptoms
moderate; weakness, ataxia, confusion
severe; reduced consciousness, seizures and ataxia
mild; nausea, vomiting, headache
management
acute < 48 hrs symptomatic IV hypertonic solution. If asymptomatic or have mild symptoms than immediately stop the medication they are currently on
chronic >48 hrs hypovolaemic give isotonic solution. Hypervolaemic; fluid restriction + loop diuretic/spironolactone
definition; serum concentration of <135 mmol can arise in euvolaemia, volume depletion etc
epidemiology; most common electrolyte imbalance, incidence high in patients that are hospitilised
Hypernatraemia
aetiology
inadequate free water intake; dementia, impaired thirst mechanism e.g. brain tumour
sodium overload; cushings syndrome, sea water drowning, deliberate ingestion of bleach
free water loss; diarrhoea, vomiting, renal failure, IV diuretics
investigations
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serum electrolyte panel with glucose, urea and creatine
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epidemiology;Hypernatraemia is more common in intensive care units, especially trauma and burns units
risk factors; old age, infancy, gastrointestinal disorder, diabetes insipidus,
signs; reduced JVP, orthostatic hypotension
symptoms; oligouria, weight loss, impaired thirst, diarrhoea and vomiting
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