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Hyponatremia, By Robyn Harris, References, Hubert, R. (2017). Gould's…
Hyponatremia
Nursing Care
Fluid restriction as needed
3% NaCl NS intravenously
Monitor serum sodium levels
Monitor response to therapy
Monitor for cardiovascular, neurological, and respiratory changes
Daily weight measurements
Assess skin and mucous membranes
Create therapeutic relationship
Refer client to a dietician to help increase their awareness around fluid and electrolyte balance
Assessment Data
Intake and output
Sodium serum levels (less than 136 mmol/L)
Vital signs
Manifestations of hyponatremia such as: irritability, rapid and thready pulse, tremors, seizures, coma, nausea, vomiting, weight loss, dry mucous membranes, headache, weakness, or confusion
Weight trends
Urine (colour)
Client Education
Educate client on signs and symptoms to watch for in a hyponatremic state
Educate client on importance of maintaining adequate fluid and nutrition intake
Increase fluid intake while exercising
Emphasize importance of follow-up and bloodwork following an incident of hyponatremia
Convey to client the importance of adherence to treatment plan
Etiology
Direct loss of sodium from the body, or an excess of water in the extracellular compartment
Causes
Excessive sweating/vomiting/diarrhea
Certain diuretic drugs
Hormonal imbalances
Early chronic renal failure
Excessive water intake
Effects
Impaired nerve conduction
Fatigue, muscle cramps, abdominal discomfort/cramps
Possible nausea or vomiting
Fluid shift into cells, resulting in hypovolemia and decreased BP
Brain cells may swell, creating confusion/headache/weakness/seizures
By Robyn Harris
References
Hubert, R. (2017). Gould's Pathophysiology for the Health Professions (6th Edition). Elsevier Health Sciences (US).
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Barry, M. A., Lok, J., & Goldsworthy, S. (2017). Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems (4th edition). Elsevier Canada.